Cultural Adaptations to Empirically Supported Treatments: a Research Agenda

The movement to establish uniform standards for the identification of empirically supported treatments (EST) has contributed to an impressive growth in the number of treatments deemed to have strong evidence of their efficacy. Those treatments meeting the most rigorous standards are often granted the label well-established and have been identified in a variety of online and print formats. An important criticism of the EST movement is the fact that the overwhelming majority of treatments identified as well-established have limited evidence of their generalizability to participants from different cultural groups. One approach to addressing this limitation has been the development and evaluation of cultural adaptations of these treatments. Although the emerging evidence frequently documents the efficacy of cultural adaptations, many questions remain. In this article, I examine the several issues related to the development and evaluation of cultural adaptations of empirically supported treatments. Specifically, I address the following questions: (1) What information should inform whether and when to adapt an existing treatment for a particular racial, ethnic, or cultural group? (2) How should cultural adaptations be made to an existing treatment? And finally, (3) how should a culturally adapted treatment be empirically evaluated?