(PS7-C54) Setting the Agenda for Suicide Prevention Intervention to Promote Health Equity: A Scoping Review of Cultural Adaptations for Dialectical Behavior Therapy

Background. Adapting mental health treatments to address unique cultural values and norms may improve intervention efficacy and retention in care. While there has been an increase in such psychotherapy, there are currently no attempts to synthesize the literature of these adaptations for suicide prevention. Cultural adaptations are of particular significance for suicide prevention given the recent increase in suicide death, including among vulnerable populations. One evidence-based suicide prevention intervention is Dialectical Behavior Therapy (DBT). Like many evidence-based treatments, DBT was created by a White, Western treatment developer, and evaluated with primarily White patients. However, DBT is now being implemented globally to meet the growing need for suicide prevention. To ensure vulnerable groups can benefit from this life-saving treatment, psychologists and library scientists are uniquely positioned to systematically understand and synthesize available literature about cultural adaptations of DBT and then propose a research agenda to reduce inequities in the delivery, receipt, and effectiveness of this suicide prevention treatment.

Methods. We are conducting a systematic scoping review of the ways DBT has been adapted for cultural contexts following the PRISMA guidelines. For the review process, we conducted a systematic search of PubMed, Embase and PsycINFO searching for articles with variations of “dialectical behavior therapy.” We evaluated which articles discussed the implementation of some component of DBT in a population that was different then the population in which DBT was originally developed, using the ADDRESSING framework (e.g. age and generational influences, developmental disability, disability acquired later in life, religion and spiritual orientation, ethnicity/race identity, socioeconomic status, sexual orientation, indigenous heritage national origin, gender). For data extraction, we will present the proportion of articles examining DBT adaptation in various ADDRESSING categories, and present findings on the process by which adaptation occurred.

Results. 2,148 abstracts were identified and reviewed. From here, 614 full text articles were identified and reviewed, with data extracted on adaptations, adaptation process, populations, and component of DBT implemented. Data extraction expected to be completed end-March 2022.

Discussion. Based on this scoping review, we will offer a synthesis of existing cultural adaptations of an evidence-based Western-developed suicide prevention treatment, set an agenda for further research to reduce inequities, and present recommendations for clinicians, programs, and potential community partners to reduce inequities at multiple system levels. This scoping review of adaptations will highlight gaps in the state of the science and propose action steps to reduce inequities in treatment accessibility for suicide prevention. While this scoping review focuses on adaptations of DBT, findings are broadly applicable to psychologists interested in adapting any treatment for a cultural context, developing a new intervention, or implementing an evidence-based practice with cultural humility.