Psicoterapias Adaptadas Culturalmente: ¿Beneficiosas, Triviales o Dañinas?

Autores/as

DOI:

https://doi.org/10.37226/rcp.v9i1.8825

Palabras clave:

psicoterapia, adaptaciones culturales, decolonización, etnicidad

Resumen

El campo de la evaluación científica de las psicoterapias ha establecido, de una manera convincente, que las psicoterapias son efectivas en minimizar angustias, síntomas y trastornos. Los efectos no son triviales, notándose cambios marcados en conductas, pensamientos, emociones y neuro-circuitos. Sin embargo, la mayoría de estos estudios provienen de países del Norte Global, entendiéndose Europa y América del Norte. Partiendo de este dato, algunos autores han señalado que los beneficios de las psicoterapias no han sido evaluados en minorías étnicas en los EE.UU. ni tampoco en personas que residen en el Sur Global. El presente artículo va dirigido a indagar si las psicoterapias pueden ser transportadas, sin adaptación alguna, a personas de otras culturas y etnias. Se plantea también la necesidad de realizar adaptaciones culturales para que éstas estén mejor alineadas con los valores, creencias y contextos culturales que no son eurocéntricos. Finalmente, se entra en el debate, propuesto mayormente por personas autoras que endosan la decolonización de la psicología, de si las psicoterapias pudieran ser dañinas y fuente de opresión por parte de terapeutas que están colonizados. Se hace un llamado de cómo podemos acercarnos a este debate con datos y estudios que diluciden si hay o no méritos en continuar adaptando las psicoterapias a personas que residen en el Sur Global.

Citas

Adams, G., Dobles, I., Gómez, L., Kurtis, T., & Molina, L. E. (2015). Decolonizing psychological science. Journal of Social and Politi-cal Psychology, 3(1), 213–238. https://doi.org/10.5964/jspp.v3i1.564

Anik, E., West, R. M., Cardno, A. G., & Mir, G. (2021). Culturally adapted psychotherapies for depressed adults: A systematic review and meta-analysis. Journal of Affective Disorders, 278, 296–310. https://doi.org/10.1016/j.jad.2020.09.080

Barkham, M., & Lambert, M. J. (2021). The efficacy and effec-tiveness of psychological therapies. In M. Barkham, W. Lutz, & L. G. Castonguay (Eds.), Bergin and Garfield’s handbook of psychotherapy and behavior change (pp. 135-189). Wiley.

Bedi, R. P. (2018). Racial, ethnic, cultural, and national disparities in counseling and psychotherapy outcome are inevitable but eliminating global mental health disparities with indigenous healing is not. Archives of Scientific Psychology, 6(1), 96–104. https://doi.org/10.1037/arc0000047

Bernal, G., Adames, C., & Almonte, M. (2015). Investigación y psicoterapia en Puerto Rico: El estado de la ciencia en Puerto Rico. Ciencias de la Conducta, 30, 68-115.

Bernal, G., Bonilla, J., & Bellido, C. (1995). Ecological validity and cultural sensitivity for outcome research: Issues for the cul-tural adaptation and development of psychosocial treatments with Hispanics. Journal of Abnormal Child Psychology, 23(1), 67–82. https://doi.org/10.1007/BF01447045

Bernal, G., & Domenech Rodríguez, M. M. (Eds.). (2012a). Cultural adaptations: Tools for evidence-based practice with diverse popula-tions. American Psychological Associa-tion. https://doi.org/10.1037/13752-000

Bernal, G., & Domenech Rodríguez, M. M. (2012b). Cultural ad-aptation in context: Psychotherapy as a historical account of adaptations. In G. Bernal & M. M. Domenech Rodríguez (Eds.), Cultural adaptations: Tools for evidence-based practice with diverse populations (pp. 3-22). American Psychological Associa-tion. https://doi.org/10.1037/13752-001

Bernal, G., & Scharrón-del-Río, M. R. (2001). Are empirically sup-ported treatments valid for ethnic minorities? Toward an al-ternative approach for treatment research. Cultural Diversity and Ethnic Minority Psychology, 7(4), 328–342. https://doi.org/10.1037/1099-9809.7.4.328

Bernal, G., Jiménez‐Chafey, M. I., & Domenech Rodríguez, M. M. (2009). Cultural adaptation of treatments: A resource for con-sidering culture in evidence‐based practice. Professional Psy-chology: Research and Practice, 40(4), 361–368. https://doi.org/10.1037/a0016401

Benish, S. G., Quintana, S., & Wampold, B. E. (2011). Culturally adapted psychotherapy and the legitimacy of myth: A direct comparison meta‐analysis. Journal of Counseling Psychology, 58(3), 279–289. https://doi.org/10.1037/a0023626

Castellanos, R., Yildiz Spinel, M., Phan, V., Orengo-Aguayo, R., Humphreys, K. L., & Flory, K. (2020). A systematic review and meta-analysis of cultural adaptations of mindfulness-based interventions for Hispanic populations. Mindfulness, 11, 317–332. https://doi.org/10.1007/s12671-019-01210-x

Chambless, D. L., & Ollendick, T. H. (2001). Empirically supported psychological interventions: Controversies and evi-dence. Annual Review of Psychology, 52, 685-716. https://doi.org/10.1146/annurev.psych.52.1.685

Chowdhary, N., Jotheeswaran, A. T., Nadkarni, A., Hollon, S. D., King, M., Jordans, M. J. D., Rahman, A., Verdeli, H., Araya, R., & Patel, V. (2014). The methods and outcomes of cultural ad-aptations of psychological treatments for depressive disorders: A systematic review. Psychological Medicine, 44, 1131-1146. https://doi.org/10.1017/S0033291713001785

Comas-Díaz, L. (1981). Effects of cognitive and behavioral group treatment on the depressive symptomatology of Puerto Rican women. Journal of Consulting and Clinical Psychology, 49(5), 627–632. https://doi.org/10.1037/0022-006X.49.5.627

Comas-Díaz, L. (2020). Liberation psychotherapy. In L. Comas-Díaz & E. Torres Rivera (Eds.), Liberation psychology (pp. 169-185). American Psychological Associa-tion. https://doi.org/10.1037/0000187-011

Comas-Díaz, L. (2021). Afro-Latinxs: Decolonization, healing, and liberation. Journal of Latinx Psychology, 9(1), 65–75. https://doi.org/10.1037/lat0000164

Cuijpers, P., Karyotaki, E., Reijnders, M., Purgato, M., & Barbui, C. (2018). Psychotherapies for depression in low- and middle-income countries: A meta-analysis. World Psychiatry, 17(1), 90–101. https://doi.org/10.1002/wps.20493

Eskici, H. S., Hinton, D. E., Jalal, B., Yurtbakan, T., & Acarturk, C. (2023). Culturally adapted cognitive behavioral therapy for Syrian refugee women in Turkey: A randomized controlled trial. Psychological Trauma: Theory, Research, Practice, and Policy, 15(2), 189–198. https://doi.org/10.1037/tra0001138

Fish, J., & Russell, S. T. (2020). Sexual orientation and gender iden-tity change efforts are unethical and harmful. American Jour-nal of Public Health, 110, 1113-1114. https://doi.org/10.2105/AJPH.2020.305765

Fonagy, P., Cottrell, D., Phillips, J., Bevington, D., Glaser, D., & Allison, E. (2015). What works for whom? Guilford Press.

Freidl, M., Wegerer, M., Litvan, Z., König, D., Alexandrowicz, R. W., Portela-Millinger, F., & Gruber, M. (2022). Determinants of quality-of-life improvements in anxiety and depressive disorders—A longitudinal study of inpatient psychothera-py. Frontiers in Psychiatry, 13, 937194. https://doi.org/10.3389/fpsyt.2022.937194

Ghelani, A., Haywood, A., & English, M. (2021). Integrating anti-oppressive practice with cognitive behavioral therapy. Social Work Today, 21, 20-23.

Giere, R. N. (1999). Science without laws. University of Chicago Press.

Giere, R. N. (2006). Scientific perspectivism. University of Chicago Press.

Gone, J. P. (2023). Community mental health services for Ameri-can Indians and Alaska Natives: Reconciling evidence-based practice and alternative psy-ence. Annual Review of Clinical Psychology, 19, 23-49. https://doi.org/10.1146/annurev-clinpsy-080921-072950

Griner, D., & Smith, T. B. (2006). Culturally adapted mental health intervention: A meta-analytic review. Psychotherapy: Theory, Research, Practice, Training, 43(4), 531–548. https://doi.org/10.1037/0033-3204.43.4.531

Hall, G. C. N., Ibaraki, A. Y., Huang, E. R., Marti, C. N., & Stice, E. (2016). A meta-analysis of cultural adaptations of psychologi-cal interventions. Behavior Therapy, 47, 993–1014. https://doi.org/10.1016/j.beth.2016.09.005

Henrich, J. (2020). The WEIRDest people in the world. Farrar, Straus and Giroux.

Hernández-Hernández, M., Waller, G., & Hardy, G. (2020). Cul-tural adaptations of cognitive behavioral therapy for Latin American patients: Unexpected findings from a systematic review. The Cognitive Behaviour Therapist, 13, e57, 1-39. https://doi.org/10.1017/S1754470X20000574

Hinton, D. E., & Patel, A. (2017). Cultural adaptations of cogni-tive behavioral therapy. Psychiatric Clinics of North America, 40(4), 701–714. https://doi.org/10.1016/j.psc.2017.08.006

Hinton, D. E. (2022). Approaches of culturally adapted cognitive behavioural therapy. In A. Maercker (Ed.), Trauma seque-lae (pp. 329-345). Springer. https://doi.org/10.1007/978-3-662-64057-9_18

Hodge, D. R., Jackson, K. F., & Vaughn, M. G. (2010). Culturally sensitive interventions and health and behavioral health youth outcomes: A meta-analytic review. Social Work in Health Care, 49, 401-423. https://doi.org/10.1080/00981380903426738

Huey, S. J., Park, A., Galán, C., & Wang, C. X. (2023). Culturally responsive cognitive behavioral therapy for ethnically diverse populations. Annual Review of Clinical Psychology, 19, 51-78. https://doi.org/10.1146/annurev-clinpsy-080921-072750

Huey, S. J., & Polo, A. J. (2008). Evidence-based psychosocial treatments for ethnic minority youth. Journal of Clinical Child and Adolescent Psychology, 37, 262–301. https://doi.org/10.1080/15374410701820174

Huey, S. J., Tilley, J. L., Jones, E. O., & Smith, C. A. (2014). The contribution of cultural competence to evidence-based care for ethnically diverse populations. Annual Review of Clinical Psychology, 10, 305-338. https://doi.org/10.1146/annurev-clinpsy-032813-153729

Ishikawa, S., Kikuta, K., Sakai, M., Mitamura, T., Motomura, N., & Hudson, J. L. (2019). A randomized controlled trial of a bidi-rectional cultural adaptation of cognitive behavior therapy for children and adolescents with anxiety disorders. Behaviour Research and Therapy, 120, 103432. https://doi.org/10.1016/j.brat.2019.103432

Koslofsky, S., & Domenech Rodríguez, M. (2016). Cultural adapta-tions to psychotherapy: Real-world applications. Clinical Case Studies, 15, 1–6. https://doi.org/10.1177/1534650116668273

Lely, J., Smida, G., Jongedijk, R., Knipscheer, J., & Kleber, R. (2019). The effectiveness of narrative exposure therapy: A review, meta-analysis and meta-regression analysis. European Journal of Psychotraumatology, 10, 1550344. https://doi.org/10.1080/20008198.2018.1550344

Leong, F. T. L. (2024). Cross-cultural theories in psychotherapy. In F. T. L. Leong (Ed.), APA handbook of psychotherapy(pp. 295-316). American Psychological Association. https://doi.org/10.1037/0000310-014

Li, X., Fang-Fang, H., Cuijpers, P., Huan, L., Eirini, K., Li, Z., Mi-guel, C., Ciharova, M., & Dobson, K. (2024). The efficacy of cognitive behavioral therapies for depression in China in comparison with the rest of the world: A systematic review and meta-analysis. Journal of Consulting and Clinical Psychology, 92, 105-117. https://doi.org/10.1037/ccp0000705

Li, S., Xi, Z., Barnett, P., Saunders, R., Shafran, R., & Pilling, S. (2023). Efficacy of culturally adapted interventions for com-mon mental disorders in people of Chinese descent: A sys-tematic review and meta-analysis. The Lancet Psychiatry, 10, 426–440. https://doi.org/10.1016/S2215-0366(23)00013-4

Linden, M., & Schermuly-Haupt, M. (2014). Definition, assess-ment, and rate of psychotherapy side effects. World Psychia-try, 13, 306-309. https://doi.org/10.1002/wps.20153

Martínez-Taboas, A. (2022). Comentarios sobre construcción social y pedofilia. Revista Caribeña de Psicología, 6, 1-15.

Martínez-Taboas, A., Francia, M., & Padilla, V. (2025). Assessing and diagnosing Latinos. In F. T. L. Leong, G. Bernal, & N. Bu-chanan (Eds.), APA Handbook of Multicultural Psychology (in press). American Psychological Association.

Mishu, M. P., Tindall, L., Kerrigan, P., & Gega, L. (2023). Cross-culturally adapted psychological interventions for the treat-ment of depression and/or anxiety among young people: A scoping review. PLOS ONE, 18(10), e0290653. https://doi.org/10.1371/journal.pone.0290653

Mullan, J. (2024). Decolonizing therapy: Oppression, historical trauma, and politicking your practice. Norton.

Muñoz, R. F., & Mendelson, T. (2005). Toward evidence-based interventions for diverse populations: The San Francisco General Hospital prevention and treatment manuals. Journal of Consulting and Clinical Psychology, 73(5), 790–799. https://doi.org/10.1037/0022-006X.73.5.790

Naeem, F., Sajid, S., Naz, S., & Phiri, P. (2023). Culturally adapted CBT—The evolution of psychotherapy adaptation frame-works and evidence. The Cognitive Behavior Therapist, 16, 1-21. https://doi.org/10.1017/S1754470X2300003X

Nicasio, A. V., Hernandez Rodriguez, J., Villalobos, B. T., Due-weke, A. R., de Arellano, M. A., & Stewart, R. W. (2022). Cul-tural and telehealth considerations for trauma‐focused treatment among Latinx youth: Case reports and clinical rec-ommendations to enhance treatment engagement. Cognitive and Behavioral Practice, 29(4), 816–830. https://doi.org/10.1016/j.cbpra.2022.06.007

Norcross, J. C., & Wampold, B. E. (Eds.). (2019). Psychotherapy relationships that work. Oxford University Press.

O’Neill, L. (2017). Cognitive behavioural therapy and anti-oppressive practice: Compatible or irreconcilable? In D. Baines (Ed.), Doing anti-oppressive practice (pp. 179-197). Fernwood Publishers.

Popper, K. R. (1972). Objective knowledge: An evolutionary ap-proach. Oxford University Press.

Rathod, S., Gega, L., Degnan, A., Pikard, J., Khan, T., Husain, N., … Naeem, F. (2018). The current status of culturally adapted mental health interventions: A practice-focused review of meta-analyses. Neuropsychiatric Disease and Treatment, 14, 165-178. https://doi.org/10.2147/NDT.S138430

Reinecke, A., Thilo, K., Croft, A., & Harmer, C. J. (2018). Early effects of exposure-based cognitive behaviour therapy on the neural correlates of anxiety. Translational Psychiatry, 8, 225. https://doi.org/10.1038/s41398-018-0277-5

Rivera, P. (2017). Freud’s speculations in ethnology: A reflection on anthropology's encounter with psychoanalysis. The Interna-tional Journal of Psychoanalysis, 98, 755-778. https://doi.org/10.1111/1745-8315.12616

Roland, A. (1989). In search of self in India and Japan: Toward a cross-cultural psychology. Princeton University Press.

Rosselló, J., & Bernal, G. (1999). The efficacy of cognitive-behavioral and interpersonal treatments for depression in Puerto Rican adolescents. Journal of Consulting and Clinical Psy-chology, 67(5), 734–745. https://doi.org/10.1037/0022-006X.67.5.734

Rosselló, J., Bernal, G., & Rivera-Medina, C. (2008). Individual and group CBT and IPT for Puerto Rican adolescents with depressive symptoms. Cultural Diversity and Ethnic Minority Psychology, 14(3), 234–245. https://doi.org/10.1037/1099-9809.14.3.234

Rubin, A. (2020). Can anti-oppressive clinical practice be compat-ible with evidence-informed clinical practice? Journal of Social Work Education, 56(4), 626-629. https://doi.org/10.1080/10437797.2020.1756541

Schauer, M., Neuner, F., & Elbert, T. (2011). Narrative exposure therapy. Hogrefe.

Siehl, S., Robjant, K., & Crombach, A. (2020). Systematic review and meta-analyses of the long-term efficacy of narrative ex-posure therapy for adults, children, and perpetra-tors. Psychotherapy Research, 31, 1–16. https://doi.org/10.1080/10503307.2020.1861166

Silveus, S. A., Schmit, M., Oliveira, J. T., & Hughes, L. (2023). Meta-analysis of culturally adapted cognitive behavioral therapy for anxiety and depression. Journal of Counseling and Development, 101, 129-142. https://doi.org/10.1002/jcad.12463

Smith, T. B., Rodríguez, M. D., & Bernal, G. (2011). Cul-ture. Journal of Clinical Psychology, 67(2), 166–175. https://doi.org/10.1002/jclp.20757

Smith, T. B., & Trimble, J. E. (2016). Foundations of multicultural psychology: Research to inform effective practice. American Psy-chological Association. https://doi.org/10.1037/14752-000

Soto, A., Smith, T., Griner, D., Domenech Rodríguez, M., & Bernal, G. (2018). Cultural adaptations and therapist multicultural competence: Two meta-analytic reviews. Journal of Clinical Psychology, 74, 1907-1923. https://doi.org/10.1002/jclp.22679

Vera, M., Obén, A., Juarba, D., Hernández, N., & Pérez-Pedrogo, C. (2021). Randomized pilot trial of cognitive-behavioral ther-apy and acceptance-based behavioral therapy in the treat-ment of Spanish-speaking Latino primary care patients with generalized anxiety disorder. Journal of Behavioral and Cognitive Practice, 31, 91-103.

Vera, M., Obén, A., Juarbe, D., Hernández, N., Kichic, R., & Hembree, E. A. (2022). A randomized clinical trial of pro-longed exposure and applied relaxation for the treatment of Latinos with posttraumatic stress disorder. Journal of Traumat-ic Stress, 35(2), 593–604. https://doi.org/10.1002/jts.22773

Vishkin, A., Kitayama, S., Berg, M. K., Diener, E., Gross-Manos, D., Ben-Arieh, A., & Tamir, M. (2023). Adherence to emotion norms is greater in individualist cultures than in collectivist cultures. Journal of Personality and Social Psychology, 124(6), 1256–1276. https://doi.org/10.1037/pspi0000409

Wright, A., Reisig, A., & Cullen, B. (2020). Efficacy and cultural adaptations of narrative exposure therapy for trauma-related outcomes in refugees/asylum-seekers: A systematic review and meta-analysis. Journal of Behavioral and Cognitive Therapy, 30, 301-314. https://doi.org/10.1016/j.jbct.2020.10.003

Zane, N., Bernal, G., & Leong, F. T. L. (Eds.). (2016). Evidence-based psychological practice with ethnic minorities. American Psycho-logical Association.

Descargas

Publicado

2025-03-12

Cómo citar

Martínez-Taboas, A. (2025). Psicoterapias Adaptadas Culturalmente: ¿Beneficiosas, Triviales o Dañinas?. Revista Caribeña De Psicología, 9(1), e8825. https://doi.org/10.37226/rcp.v9i1.8825

Número

Sección

Debates, Reacciones y Controversias Teóricas

Artículos más leídos del mismo autor/a