Cultural Adaptation of a Low-Intensity Group Psychological Intervention for Syrian Refugees

Aemal Akhtar*, Michelle Engels, Ahmad Bawaneh, Martha Bird, Richard Bryant, Pim Cuijpers, Pernille Hansen, Hadeel Al-Hayek, Zeynep Ilkkursun, Gulsah Kurt, Marit Sijbrandij, James Underhill, Ceren Acarturk

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review


Given the increasing use of low-intensity psychological interventions in humanitarian mental health and psychosocial support work, more attention is needed to strengthen the intersection between evidence-based interventions and cultural contextualisation. Undertaking the process of cultural adaptation ensures the appropriateness and acceptability of psychological interventions in these contexts. We present the process and results of conducting a cultural adaptation for the Group Problem Management Plus (GroupPM+) intervention, for Syrian refugees across two contexts; Jordan in camp settings and Turkey in urban settings. The first step of the adaptation was to conduct a rapid qualitative assessment following the Design, Implementation, Monitoring and Evaluation model proceeded by cognitive interviews and a workshop designed to apply changes according to the Bernal framework. Based on the results, a total of 82 changes were proposed across the intervention manual, training, supervision and implementation protocols. Changes ranged from minor amendments to terminology to broader changes to how metaphors, stories and illustrations are presented during the intervention. Additionally, two substantial adaptations were suggested: (1) the addition of a session designed to enhance family engagement, and (2) the development of a male case study. Changes were incorporated prior to the implementation of the GroupPM+ intervention in Jordan and Turkey.

Original languageEnglish
Pages (from-to)48-57
Number of pages10
Issue number1
Early online date31 Mar 2021
Publication statusPublished - Mar 2021

Bibliographical note

Funding Information:
This work was supported by a National Health and Medical Research Council–European Union Grant [1142605] and a European Union Horizon 2020 Grant [733337]. The study funders had no role in study design; collection, management, analysis and interpretation of data; writing of the report; or the decision to submit the report for publication.

Publisher Copyright:
© 2021 Lippincott Williams and Wilkins. All rights reserved.

Copyright 2021 Elsevier B.V., All rights reserved.


  • cultural adaptation
  • Jordan
  • psychological intervention
  • Syrian refugees
  • Turkey


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