Parameters for Creating Culturally Sensitive CBT: Implementing CBT in Global Settings

The current article is a commentary on the article, “A Common Elements Approach for Adult Mental Health Problems in Low- and Middle-Income Countries,” which describes a form of transdiagnostic CBT and its implementation among a highly traumatized Burmese and Iraqi group. Murray et al.’s (this issue) article is one of several new studies indicating the efficacy of CBT in global contexts. In this commentary, we suggest a set of parameters to create culturally sensitive CBT in global settings in a way to maximize efficacy and effectiveness. When applicable, we will discuss ways in which these parameters are illustrated by Murray et al. in this pilot study. These parameters can be used more generally to design culturally sensitive CBT studies in global contexts and to evaluate such studies. Some examples of these parameters are culturally appropriate framing of CBT techniques, assessing and addressing key local complaints (e.g., somatic symptoms) and local catastrophic cognitions, and incorporating key local sources of recovery and resilience.