DepressionCA-CBTNCT07109973
"Culturally Adapted CBT for Depression in Arab and Asian Adolescents in the UAE (CA-CBT)"
A study testing Culturally Adapted Cognitive Behavioural Therapy (CA-CBT) and Treatment-as-Usual (TAU) in people with Depression and Adolescent Depression, run by Bath Spa University Academic Centre RAK at 1 site in United Arab Emirates.
Trial summary
This study evaluated the effectiveness of a culturally adapted form of Cognitive Behavioural Therapy (CA-CBT) for reducing depression among Arab and Asian adolescents in the United Arab Emirates (UAE). Read more about this study
- Who is it for?
- Ages 13 to 18 years
- Conditions the study is for
- Depression, Adolescent Depression, Mental Health
- What is being tested?
- Culturally Adapted Cognitive Behavioural Therapy (CA-CBT) and Treatment-as-Usual (TAU)
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 175 participants
- Where
- 1 siteUnited Arab Emirates
- Study dates
- 15 Jun 2024to 20 Apr 2025
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 13 to 18 years
- All sexes
- No healthy volunteers
- Child, Adult
Who may be able to join
- Adolescents aged 13 to 18 years old
- Screening positive for mild to moderate depressive symptoms based on the PHQ-9
- Able to understand and communicate in English, Arabic, or Tagalog
- Parental/guardian consent and participant assent provided
- Willing to attend all 8 weekly therapy sessions
Who cannot join
- Currently undergoing structured psychotherapy or psychiatric treatment
- Diagnosed with severe mental disorders (e.g., psychosis, bipolar disorder)
- Active suicidal ideation requiring emergency intervention
- Significant cognitive or developmental delays that impede participation
- Unwilling or unable to commit to full program attendance
- -
Trial locations and contacts
1 site in 1 country.
United Arab Emirates1 site
Bath Spa University Academic Centre - Ras Al Khaimah
Ras al-Khaimah, United Arab Emirates, 00000
About this study
Official title: "Efficacy of a Culturally Adapted Cognitive Behavioral Therapy (CA-CBT) for Depression Among Arab and Asian Adolescents in the United Arab Emirates: A Randomized Controlled Trial"
This study evaluated the effectiveness of a culturally adapted form of Cognitive Behavioural Therapy (CA-CBT) for reducing depression among Arab and Asian adolescents in the United Arab Emirates (UAE). Depression is a major concern for adolescents in the region, where cultural differences and stigma can make standard mental health treatments less effective.
A total of 175 adolescents aged 13-18, from Filipino, Arab, and other Asian backgrounds, were recruited from schools and communities across the UAE. Participants were randomly assigned to one of two groups: (1) an 8-week CA-CBT program delivered in weekly sessions, or (2) a treatment-as-usual (TAU) group who received available community support.
Read more
The CA-CBT program was carefully adapted to reflect the cultural and religious values of participants, including family involvement, use of familiar metaphors, and respect for beliefs about mental illness. The goal was to make therapy more relatable, acceptable, and effective.
The main outcome measured was the severity of depression symptoms before and after the 8-week period. Other outcomes included anxiety, stress levels, and dropout rates. The results showed that CA-CBT significantly reduced depression symptoms more than standard care. The program also had fewer dropouts, meaning more students stayed in therapy.
These findings suggest that adapting evidence-based therapy to reflect cultural values can improve mental health outcomes in diverse communities. The research supports the use of culturally sensitive treatments in school and community mental health programs across multicultural societies like the UAE.
Read the detailed description
This study was a two-arm, parallel-group, single-blind randomized controlled trial (RCT) conducted to assess the efficacy of a newly developed Culturally Adapted Cognitive Behavioural Therapy (CA-CBT) for adolescent depression in the multicultural context of the UAE. The trial involved 175 adolescents aged 13-18 from Arab, Filipino, and other Asian backgrounds who met the inclusion criteria of scoring ≥10 on the PHQ-A (Patient Health Questionnaire for Adolescents). Participants were randomized to either the CA-CBT intervention group or a treatment-as-usual (TAU) control group.
The CA-CBT group received an 8-week manualized intervention tailored to the cultural values of Arab and Asian adolescents, including content adaptations (e.g., academic and family stress in Filipinos, spiritual concerns in Arabs), process modifications (e.g., family involvement, religious framing), and therapist training. The Southampton Adaptation Framework (SAF-CaCBT) and PEN-3 model guided the cultural adaptation. Sessions were delivered by trained facilitators fluent in English, with support in Arabic and Tagalog.
The TAU group received standard mental health resources as available in the community, including school counselors and primary care services. All participants were assessed at baseline (T0) and after the intervention (T1) using validated tools including PHQ-A for depression and DASS-21 for anxiety and stress.
Primary analysis used a 2 (Group) x 2 (Time) repeated measures ANOVA. Results showed a significant time-by-group interaction, with CA-CBT participants experiencing a greater reduction in depressive symptoms (mean difference = -6.8, p < .001, ηp² = .095) compared to the TAU group. Dropout rates were significantly lower in the CA-CBT group (10.2%) than in the TAU group (19.5%), supporting higher engagement and cultural congruence.
The study protocol received ethical approval from the Bath Spa University Academic Centre RAK IRB (Ref # BSU-RAK-PSYCH-2025-0011) and was registered prospectively (ISRCTN14751844).
The findings demonstrate that CA-CBT is a culturally valid and effective intervention for adolescent depression in diverse populations and support the integration of culturally tailored therapies in school and community-based mental health care systems.
- Being tested
- Culturally Adapted Cognitive Behavioural Therapy (CA-CBT), Treatment-as-Usual (TAU)
- Keywords
- Cognitive Behavioural Therapy, Culturally Adapted CBT, Depression, anxiety, Stress
- Medical subject headings
- Depression, Psychological Well-Being, Stress, Psychological, Anxiety Disorders
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Culturally Adapted Cognitive Behavioural Therapy (CA-CBT)Behavioural
CA-CBT is an 8-week manualized therapy program based on core CBT principles, adapted for Arab and Asian adolescents in the UAE. Adaptations followed the Southampton Adaptation Framework (SAF-CaCBT) and the PEN-3 model, including culturally relevant metaphors, integration of religious/spiritual beliefs, family involvement, and emphasis on academic and familial stressors. Sessions were delivered weekly for 60 minutes by trained therapists, with support in English, Arabic, and Tagalog.
Participants in the TAU group received standard care available within their community. This included optional access to school counselors, general practitioners, or local mental health clinics. No structured psychotherapy or manualized intervention was provided by the research team. This arm served as a pragmatic comparator to evaluate the added value of the Culturally Adapted Cognitive Behavioural Therapy (CA-CBT) intervention.
| Study group | Role | What they receive |
|---|---|---|
| CA-CBT Intervention Group | Experimental | Participants in this group received an 8-week manualized Culturally Adapted Cognitive Behavioural Therapy (CA-CBT) program. Sessions were conducted weekly for 60 minutes by trained therapists with culturally appropriate modifications based on the Southampton Adaptation Framework and the PEN-3 model. Adaptations included religious/spiritual integration, family involvement, and culturally relevant examples. Receives: Behavioral: Culturally Adapted Cognitive Behavioural Therapy (CA-CBT) |
| Treatment-as-Usual (TAU) Group | Active comparator | Participants in this group received standard care as available in their communities. This included access to school counselors, general practitioners, or local mental health clinics. Participants were free to seek or continue any support services of their choice. No structured psychotherapy was administered by the research team. Receives: Other: Treatment-as-Usual (TAU) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in depressive symptoms measured by the PHQ-9 scale
The Patient Health Questionnaire-9 (PHQ-9) will be used to assess the severity of depressive symptoms. Scores range from 0 to 27, with higher scores indicating greater depressive symptom severity. The PHQ-9 is a validated and widely used self-report tool.
Measured: Baseline and post-intervention (8 weeks)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted7 Aug 2025
- Study start15 Jun 2024
- Primary completion20 Jan 2025
- Study completion20 Apr 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for DepressionStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 175 participants (actual)
Sponsor and investigators
- Lead sponsor
- Bath Spa University Academic Centre RAK
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Jamal D. Magantor, Bath Spa University Academic Centre RAK
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07109973
- Sponsor's protocol ID
- BSU-RAK-PSYCH -2025-0011
- Other IDs
- BSU-RAK-PSYCH-2025-0011
- Acronym
- CA-CBT
- Status last verified
- Jul 2025
- First submitted
- 31 Jul 2025
- Last updated
- 7 Aug 2025
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Rathod S, Gega L, Degnan A, et al. The current state of culturally adapted mental health interventions: a meta-review of meta-analyses. Psychol Med. 2018;48(11):1868-1877. doi:10.1017/S0033291717003212
Airhihenbuwa CO. Health and Culture: Beyond the Western Paradigm. Thousand Oaks: Sage Publications; 1995.
Hinton DE, Jalal B, Weiss MG. Cultural adaptation of cognitive behavioral therapy (CBT). Transcult Psychiatry. 2016;53(6):683-706. doi:10.1177/1363461516678326
Study at a glance
From the registry record, last updated by the sponsor on 7 Aug 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- "Efficacy of a Culturally Adapted Cognitive Behavioral Therapy (CA-CBT) for Depression Among Arab and Asian Adolescents in the United Arab Emirates: A Randomized Controlled Trial"
- ClinicalTrials.gov ID
- NCT07109973
- Acronym / sponsor ID
- CA-CBT / BSU-RAK-PSYCH -2025-0011
- Keywords
- Cognitive Behavioural Therapy, Culturally Adapted CBT, Depression, anxiety, Stress
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 175 participants (actual)
- Lead sponsor
- Bath Spa University Academic Centre RAKUniversity, hospital or other
- Study start
- 15 Jun 2024 (actual)
- Primary completion
- 20 Jan 2025 (actual)
- Study completion
- 20 Apr 2025 (actual)
- First posted
- 7 Aug 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study evaluated the effectiveness of a culturally adapted form of Cognitive Behavioural Therapy (CA-CBT) for reducing depression among Arab and Asian adolescents in the United Arab Emirates (UAE). Depression is a major concern for adolescents in the region, where cultural differences and stigma can make standard mental health treatments less effective.
A total of 175 adolescents aged 13-18, from Filipino, Arab, and other Asian backgrounds, were recruited from schools and communities across the UAE. Participants were randomly assigned to one of two groups: (1) an 8-week CA-CBT program delivered in weekly sessions, or (2) a treatment-as-usual (TAU) group who received available community support.
The CA-CBT program was carefully adapted to reflect the cultural and religious values of participants, including family involvement, use of familiar metaphors, and respect for beliefs about mental illness. The goal was to make therapy more relatable, acceptable, and effective.
The main outcome measured was the severity of depression symptoms before and after the 8-week period. Other outcomes included anxiety, stress levels, and dropout rates. The results showed that CA-CBT significantly reduced depression symptoms more than standard care. The program also had fewer dropouts, meaning more students stayed in therapy.
These findings suggest that adapting evidence-based therapy to reflect cultural values can improve mental health outcomes in diverse communities. The research supports the use of culturally sensitive treatments in school and community mental health programs across multicultural societies like the UAE.
Detailed description
This study was a two-arm, parallel-group, single-blind randomized controlled trial (RCT) conducted to assess the efficacy of a newly developed Culturally Adapted Cognitive Behavioural Therapy (CA-CBT) for adolescent depression in the multicultural context of the UAE. The trial involved 175 adolescents aged 13-18 from Arab, Filipino, and other Asian backgrounds who met the inclusion criteria of scoring ≥10 on the PHQ-A (Patient Health Questionnaire for Adolescents). Participants were randomized to either the CA-CBT intervention group or a treatment-as-usual (TAU) control group.
The CA-CBT group received an 8-week manualized intervention tailored to the cultural values of Arab and Asian adolescents, including content adaptations (e.g., academic and family stress in Filipinos, spiritual concerns in Arabs), process modifications (e.g., family involvement, religious framing), and therapist training. The Southampton Adaptation Framework (SAF-CaCBT) and PEN-3 model guided the cultural adaptation. Sessions were delivered by trained facilitators fluent in English, with support in Arabic and Tagalog.
The TAU group received standard mental health resources as available in the community, including school counselors and primary care services. All participants were assessed at baseline (T0) and after the intervention (T1) using validated tools including PHQ-A for depression and DASS-21 for anxiety and stress.
Primary analysis used a 2 (Group) x 2 (Time) repeated measures ANOVA. Results showed a significant time-by-group interaction, with CA-CBT participants experiencing a greater reduction in depressive symptoms (mean difference = -6.8, p < .001, ηp² = .095) compared to the TAU group. Dropout rates were significantly lower in the CA-CBT group (10.2%) than in the TAU group (19.5%), supporting higher engagement and cultural congruence.
The study protocol received ethical approval from the Bath Spa University Academic Centre RAK IRB (Ref # BSU-RAK-PSYCH-2025-0011) and was registered prospectively (ISRCTN14751844).
The findings demonstrate that CA-CBT is a culturally valid and effective intervention for adolescent depression in diverse populations and support the integration of culturally tailored therapies in school and community-based mental health care systems.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| CA-CBT Intervention Group | Experimental | Behavioral: Culturally Adapted Cognitive Behavioural Therapy (CA-CBT)Participants in this group received an 8-week manualized Culturally Adapted Cognitive Behavioural Therapy (CA-CBT) program. Sessions were conducted weekly for 60 minutes by trained therapists with culturally appropriate modifications based on the Southampton Adaptation Framework and the PEN-3 model. Adaptations included religious/spiritual integration, family involvement, and culturally relevant examples. |
| Treatment-as-Usual (TAU) Group | Active comparator | Other: Treatment-as-Usual (TAU)Participants in this group received standard care as available in their communities. This included access to school counselors, general practitioners, or local mental health clinics. Participants were free to seek or continue any support services of their choice. No structured psychotherapy was administered by the research team. |
Who may qualify
- Ages
- 13 to 18 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult
Key inclusion criteria (5 listed)
- Adolescents aged 13 to 18 years old
- Screening positive for mild to moderate depressive symptoms based on the PHQ-9
- Able to understand and communicate in English, Arabic, or Tagalog
- Parental/guardian consent and participant assent provided
- Willing to attend all 8 weekly therapy sessions
Key exclusion criteria (6 listed)
- Currently undergoing structured psychotherapy or psychiatric treatment
- Diagnosed with severe mental disorders (e.g., psychosis, bipolar disorder)
- Active suicidal ideation requiring emergency intervention
- Significant cognitive or developmental delays that impede participation
- Unwilling or unable to commit to full program attendance
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Culturally Adapted Cognitive Behavioural Therapy (CA-CBT)CA-CBT is an 8-week manualized therapy program based on core CBT principles, adapted for Arab and Asian adolescents in the UAE. Adaptations followed the Southampton Adaptation Framework (SAF-CaCBT) and the PEN-3 model, including culturally relevant metaphors, integration of religious/spiritual beliefs, family involvement, and emphasis on academic and familial stressors. Sessions were delivered weekly for 60 minutes by trained therapists, with support in English, Arabic, and Tagalog. | Behavioural | CA-CBT Intervention Group |
| Treatment-as-Usual (TAU)Participants in the TAU group received standard care available within their community. This included optional access to school counselors, general practitioners, or local mental health clinics. No structured psychotherapy or manualized intervention was provided by the research team. This arm served as a pragmatic comparator to evaluate the added value of the Culturally Adapted Cognitive Behavioural Therapy (CA-CBT) intervention. | Other | Treatment-as-Usual (TAU) Group |
Primary outcome
Change in depressive symptoms measured by the PHQ-9 scale
Time frame: Baseline and post-intervention (8 weeks)
The Patient Health Questionnaire-9 (PHQ-9) will be used to assess the severity of depressive symptoms. Scores range from 0 to 27, with higher scores indicating greater depressive symptom severity. The PHQ-9 is a validated and widely used self-report tool.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 7 Aug 2025.
- Results publicationRathod S, Gega L, Degnan A, et al. The current state of culturally adapted mental health interventions: a meta-review of meta-analyses. Psychol Med. 2018;48(11):1868-1877. doi:10.1017/S0033291717003212
- Results publicationAirhihenbuwa CO. Health and Culture: Beyond the Western Paradigm. Thousand Oaks: Sage Publications; 1995.
- Results publicationHinton DE, Jalal B, Weiss MG. Cultural adaptation of cognitive behavioral therapy (CBT). Transcult Psychiatry. 2016;53(6):683-706. doi:10.1177/1363461516678326
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Culturally Adapted Cognitive Behavioural Therapy (CA-CBT) and Treatment-as-Usual (TAU) in people with Depression and Adolescent Depression, run by Bath Spa University Academic Centre RAK at 1 site in United Arab Emirates.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 7 Aug 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United Arab Emirates. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in depressive symptoms measured by the PHQ-9 scale (time frame: Baseline and post-intervention (8 weeks)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07109973, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 Aug 2025.