"Culturally Adapted CBT for Depression in Arab and Asian Adolescents in the UAE (CA-CBT)"

NCT07109973 | Completed

• 2 other identifiers: BSU-RAK-PSYCH -2025-0011BSU-RAK-PSYCH-2025-0011
• Study Type: interventional
• Target: 175
• Locations: 1 country
• Sites: 1

Brief Summary

This study evaluated the effectiveness of a culturally adapted form of Cognitive Behavioural Therapy (CA-CBT) for reducing depression among Arab and Asian adolescents in the United Arab Emirates (UAE). Depression is a major concern for adolescents in the region, where cultural differences and stigma can make standard mental health treatments less effective. A total of 175 adolescents aged 13-18, from Filipino, Arab, and other Asian backgrounds, were recruited from schools and communities across the UAE. Participants were randomly assigned to one of two groups: (1) an 8-week CA-CBT program delivered in weekly sessions, or (2) a treatment-as-usual (TAU) group who received available community support. The CA-CBT program was carefully adapted to reflect the cultural and religious values of participants, including family involvement, use of familiar metaphors, and respect for beliefs about mental illness. The goal was to make therapy more relatable, acceptable, and effective. The main outcome measured was the severity of depression symptoms before and after the 8-week period. Other outcomes included anxiety, stress levels, and dropout rates. The results showed that CA-CBT significantly reduced depression symptoms more than standard care. The program also had fewer dropouts, meaning more students stayed in therapy. These findings suggest that adapting evidence-based therapy to reflect cultural values can improve mental health outcomes in diverse communities. The research supports the use of culturally sensitive treatments in school and community mental health programs across multicultural societies like the UAE.

Conditions

Depression; Adolescent Depression; Mental Health; Psychological Stress; Anxiety Disorder

Keywords

Cognitive Behavioural Therapy; Culturally Adapted CBT; Depression; anxiety; Stress

Outcome Measures

Primary Outcomes (1)

• Change in depressive symptoms measured by the PHQ-9 scale

  The Patient Health Questionnaire-9 (PHQ-9) will be used to assess the severity of depressive symptoms. Scores range from 0 to 27, with higher scores indicating greater depressive symptom severity. The PHQ-9 is a validated and widely used self-report tool.

  Baseline and post-intervention (8 weeks)

Study Arms (2)

CA-CBT Intervention Group

EXPERIMENTAL

Participants in this group received an 8-week manualized Culturally Adapted Cognitive Behavioural Therapy (CA-CBT) program. Sessions were conducted weekly for 60 minutes by trained therapists with culturally appropriate modifications based on the Southampton Adaptation Framework and the PEN-3 model. Adaptations included religious/spiritual integration, family involvement, and culturally relevant examples.

Behavioral: Culturally Adapted Cognitive Behavioural Therapy (CA-CBT)

Treatment-as-Usual (TAU) Group

ACTIVE COMPARATOR

Participants in this group received standard care as available in their communities. This included access to school counselors, general practitioners, or local mental health clinics. Participants were free to seek or continue any support services of their choice. No structured psychotherapy was administered by the research team.

Other: Treatment-as-Usual (TAU)

Interventions

Culturally Adapted Cognitive Behavioural Therapy (CA-CBT) BEHAVIORAL

CA-CBT is an 8-week manualized therapy program based on core CBT principles, adapted for Arab and Asian adolescents in the UAE. Adaptations followed the Southampton Adaptation Framework (SAF-CaCBT) and the PEN-3 model, including culturally relevant metaphors, integration of religious/spiritual beliefs, family involvement, and emphasis on academic and familial stressors. Sessions were delivered weekly for 60 minutes by trained therapists, with support in English, Arabic, and Tagalog.

CA-CBT Intervention Group

Treatment-as-Usual (TAU) OTHER

Participants in the TAU group received standard care available within their community. This included optional access to school counselors, general practitioners, or local mental health clinics. No structured psychotherapy or manualized intervention was provided by the research team. This arm served as a pragmatic comparator to evaluate the added value of the Culturally Adapted Cognitive Behavioural Therapy (CA-CBT) intervention.

Treatment-as-Usual (TAU) Group

Eligibility Criteria

• Age: 13 Years - 18 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Adolescents aged 13 to 18 years old
• Screening positive for mild to moderate depressive symptoms based on the PHQ-9
• Able to understand and communicate in English, Arabic, or Tagalog
• Parental/guardian consent and participant assent provided
• Willing to attend all 8 weekly therapy sessions

You may not qualify if:

• Currently undergoing structured psychotherapy or psychiatric treatment
• Diagnosed with severe mental disorders (e.g., psychosis, bipolar disorder)
• Active suicidal ideation requiring emergency intervention
• Significant cognitive or developmental delays that impede participation
• Unwilling or unable to commit to full program attendance

Sponsors & Collaborators

• Bath Spa University Academic Centre RAK: lead

Study Sites (1)

Bath Spa University Academic Centre - Ras Al Khaimah

Ras al-Khaimah, United Arab Emirates, 00000, United Arab Emirates

Location

Related Publications (3)

• Rathod S, Gega L, Degnan A, et al. The current state of culturally adapted mental health interventions: a meta-review of meta-analyses. Psychol Med. 2018;48(11):1868-1877. doi:10.1017/S0033291717003212

  BACKGROUND

• Airhihenbuwa CO. Health and Culture: Beyond the Western Paradigm. Thousand Oaks: Sage Publications; 1995.

  BACKGROUND

• Hinton DE, Jalal B, Weiss MG. Cultural adaptation of cognitive behavioral therapy (CBT). Transcult Psychiatry. 2016;53(6):683-706. doi:10.1177/1363461516678326

  BACKGROUND

MeSH Terms

Conditions

Depression; Psychological Well-Being; Stress, Psychological; Anxiety Disorders

Condition Hierarchy (Ancestors)

Behavioral Symptoms; Behavior; Personal Satisfaction; Mental Disorders

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Program Leader , Department of Psychology, Bath Spa University Academic Centre - RAK

Study Record Dates

• First Submitted: July 31, 2025
• First Posted: August 7, 2025
• Study Start: June 15, 2024
• Primary Completion: January 20, 2025
• Study Completion: April 20, 2025
• Last Updated: August 7, 2025

Record last verified: 2025-07

Data Sharing

• IPD Sharing: Will not share

Locations

AE (1)