Cultural Adaptation

PHP used multilingual delivery in English, Urdu, and Punjabi as a practical and culturally respectful adaptation. Adaptations preserved core therapeutic components while changing delivery, examples, and family engagement for local contexts. PHP's group format was considered aligned with collectivist values while its assertiveness content challenged some gender and family norms. PEDAL adapted FAST for Latino patients through translation, cultural elements, and Mexican cultural values. Cultural modifications commonly involved family engagement, locally meaningful materials, technology, and individualisation. Some adaptations changed practical content, such as replacing cheque-writing with cash management for Latino populations. Many British South Asian women are reluctant to approach services they perceive as culturally insensitive. The UCLA programme has been adapted across China, Turkey, Spain, and France. PHP's cultural adaptation was co-developed with South Asian women and facilitators rather than limited to surface-level changes.