A critical review of culturally sensitive treatments for depression: recommendations for intervention and research.

Recent meta-analyses and reviews have showed that culturally adapted mental health interventions are more effective for racial and ethnic minorities than traditional unadapted psychotherapy. Despite the advances in providing culturally sensitive mental health services, disparities among racial and ethnic minorities still exist. As a body of literature on culturally sensitive treatments accumulates, there is a need to examine what makes a treatment for specific presenting problems culturally sensitive. This article presents a critical review of existing culturally sensitive treatments for depression because it is one of the most common and debilitating mental disorders. In particular, we examined what treatment modalities were used, what types of adaptations were implemented, and what populations were targeted. The conceptual framework this review uses to categorize existing culturally sensitive treatments includes a top-down, a bottom-up, or an integrative approach. The review reveals that the majority of culturally sensitive treatments for depression employed an evidence-based bottom-up approach, which involved general and practical adaptations, such as translating materials or infusing specific cultural values. Most studies used cognitive-behavioral strategies and included Latinos and African Americans. Recommendations and future directions in interventions and research are discussed to decrease mental health care disparities among ethnic minorities.