Impact of cultural adaptation in digital narrative therapy on psychological distress: a randomized controlled trial

Abstract

This study delves into how narrative therapy, a tool that empowers individuals to reshape their life stories, intersects with digital methods and cultural considerations to influence mental health outcomes. While we embrace digital mental health tools, cultural intricacies are frequently ignored, potentially impacting the intervention’s effectiveness. This study addresses this oversight, investigating how cultural adaptation links with intervention efficacy, and investigates whether culturally sensitive interventions lead to improved mental health outcomes, uncover unique cultural strengths, influence help-seeking decisions, and resonate more effectively with specific subgroups. Participants in this study included University of Regina students (N=130) aged at least 18 years without significant recent trauma, substance use, mania, or psychosis. A mixed-methods approach was employed, integrating quantitative analysis through paired sample t-tests, one-way analyses of variance (ANOVAs), and multiple linear regressions along with qualitative thematic analysis of responses provided as part of the intervention. Findings revealed a significant improvement in feelings of tenseness and self-confidence post-intervention. However, no significant difference in anxiety scores from pre- to post-test were identified, suggesting that the brief nature of the intervention may not have been sufficient to cause measurable changes in levels of anxiety. Additionally, no significant difference between the outcomes from the culturally adapted and non-culturally adapted groups were found, which implies that mental health professionals can provide their patients with the option to choose between either type of intervention, advocating for a more inclusive and effective mental health treatment landscape.