Cultural adaptations and therapist multicultural competence: Two meta-analytic reviews

J Clin Psychol. 2018 Nov;74(11):1907-1923. doi: 10.1002/jclp.22679. Epub 2018 Aug 8.


Mental health treatments can be more effective when they align with the culture of the client and when therapists demonstrate multicultural competence. We summarize relevant research findings in two meta-analyses. In the meta-analysis examining culturally adapted interventions, the average effect size across 99 studies was d = 0.50 (0.35 after accounting for publication bias). In the second meta-analysis on 15 studies of therapist cultural competence, the results differed by rating source: Client-rated measures of therapist cultural competence correlated strongly (r = 0.38) with treatment outcomes but therapists' self-rated competency did not (r = 0.06). We describe patient considerations and research limitations. We conclude with research supported therapeutic practices that help clients benefit from modifications to treatment related to culture.

Keywords: cultural adaptations; meta-analysis; multicultural competencies; multicultural psychotherapy; treatment adaptations.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Cultural Competency / psychology*
  • Cultural Diversity*
  • Humans
  • Professional-Patient Relations
  • Psychotherapy / methods*
  • Research
  • Treatment Outcome