Chapter 5 - Cognitive-behavioural therapy around the globe

The overwhelming burden of unmet mental health need occurs in low- and middle-income countries (LMIC). A robust body of research demonstrates the efficacy of cognitive behavioral therapy, one of the most commonly used and widely applicable therapies for preventing and treating mental disorders. However, the majority of this research originates in high-income countries. The transportability of cognitive behavioral therapy models from high-income country settings to LMIC is not always appropriate or guaranteed. Culture, language, poverty, human resource shortages, health system capacity, and other social and structural determinants of health may adversely affect engagement in and response to therapeutic approaches designed in high-income countries and used without adaptation in LMIC. We need scientific methods that facilitate the rigorous adaptation of efficacious cognitive behavioral therapy tested in high-income country settings to LMIC. Promoting the translation of cognitive behavioral therapy via adaptation holds great promise for helping to close the mental health treatment gap in LMIC.