In this study we examine the degree to which a manualized cognitive-behavioral therapy intervention can be adapted to be culturally sensitive in treating depressed low-income African American women with multiple stressors. We describe the adaptations we made to an existing intervention, a group treatment developed for depressed low-income medical patients. We also describe our evaluation of the adapted treatment in which outcomes of African American women treated in the culturally adapted group were compared to African American women treated in the non-adapted group. Following treatment, women in the adapted group exhibited a larger drop in average BDI scores. Implications are discussed in terms of challenges related to the development and evaluation of culturally adapted treatment.