Contextual Adaptation of Psychological Interventions for Common Mental Health Conditions in Young People in Low- and Middle-Income Countries—A Systematic Review

Adapting psychological interventions from High-Income Countries (HICs) to Low- and Middle-Income Countries (LMICs) is often needed because developing new treatments requires significant resources. Contextual adaptation improves acceptability, practicality, and effectiveness in diverse settings. However, few studies clearly describe the frameworks guiding these adaptations. Our review examined the literature on conceptual and procedural frameworks for culturally adapting psychological interventions aimed at youth depression and anxiety and identified common challenges. We searched several databases for studies that had culturally adapted psychological treatments in LMICs. We used the Reporting Cultural Adaptation in Psychological Trials (RECAPT) framework to gather data and guide the thematic analysis. We reviewed 25 studies; most (n = 23) reported formative work but lacked detailed, step-by-step descriptions of the adaptation processes. When frameworks were described, processes were often unclear, making it difficult to determine what constitutes adaptation and how to implement it. The review underscores the need for more structured, detailed reporting of adaptation frameworks. Clearer documentation is vital for better understanding and successful implementation. Based on these findings, we suggest ways to improve reporting practices for the cultural adaptation of psychological interventions. We recommend (1) explicit reporting of step-by-step adaptation processes using established frameworks and (2) systematic documentation of cultural and contextual modifications based on identified conceptual and process frameworks using reporting guidelines such as RECAPT.