A systematic review culturally adapted Cognitive Behavioral Therapy (CaCBT) for Arabic-speaking populations including North African subgroups

Abstract Background Cognitive behavioral therapy (CBT) is an effective treatment for common mental disorders. However, most CBT protocols have been developed within Western cultural frameworks, which may limit their relevance for culturally diverse populations. Culturally adapted CBT (CaCBT) seeks to enhance treatment acceptability and effectiveness by integrating linguistic, cultural, religious, and contextual factors. Despite growing interest in culturally adapted interventions, evidence regarding Arabic-speaking populations, including North African subgroups, remains fragmented. Methods Following PRISMA 2020 guidelines, a systematic search was conducted in Cochrane Library, PubMed, PsycInfo, Scopus, and OpenAlex from inception to June 2025. Empirical studies assessing CaCBT among among Arabic-speaking populations, including North African subgroups in Europe or North Africa were included. Study selection involved independent double screening, and findings were synthesized narratively. Results Thirteen studies met the inclusion criteria, including randomized controlled trials, qualitative studies, case reports, an exploratory dissemination study, and two review articles. CaCBT was associated with reductions in depression, anxiety, and post-traumatic stress disorder symptoms, particularly in internet-based formats. Common adaptations included language, culturally relevant metaphors, social norms, and occasionally religious or spiritual elements. High attrition rates were frequently reported in digital interventions. Conclusion The available evidence suggests that culturally adapted CBT may be a promising intervention for Arabic-speaking populations, including North African subgroups. However, conclusions should be interpreted cautiously given the methodological heterogeneity of the evidence base, the predominance of studies involving broader Arabic-speaking populations, high attrition rates in digital interventions, and the limited reporting of participants’ countries of origin and migration-related characteristics. Future research should employ more rigorous designs, recruit more diverse and representative samples, and improve the reporting of cultural adaptation processes to strengthen the evidence base and inform culturally responsive mental health care.