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abstract: 'Large variations of inequalities in rates of mental health disorders and
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access to mental health care exist within and between countries.
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Globally, disparities range from countries where there is little
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provision to those where, despite the availability of evidence-based
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mental health care, service access and outcomes are mediated by social
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factors such as socio-economic status, race/ethnicity, and culture. This
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is salient because increasingly diverse populations are inevitably
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created with globalization. We posit that in multicultural contexts,
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effective therapeutic engagement requires therapists who are competent
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and confident to work with diversity and difference, utilizing insights
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into their own as well as their clients'' internal and external worlds.
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Although there are many reasons why psychotherapies can be insensitive
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and harmful, for example, the inherent power imbalance in therapeutic
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relationships, a lack of awareness of cultural and ethnic variation and
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needs are among them. Acquisition of `cultural competence'' and
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increasing availability of culturally-adapted interventions should, in
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theory, enable practitioners to work with a range of individuals with
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whom they might have little in common. However, whilst cultural
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adaptation appears promising, there are concerns regarding its viability
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as a strategy for tackling disparities in access to psychological care.
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Evidence for cultural competency is patchy at best. We show how and why
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delivering effective psychotherapy in the twenty-first century requires
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a paradigm shift from current approaches to truly integrated models,
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developed in collaboration with recipients of care. Coproducing
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interventions, training, and means of evaluating them with clients
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necessitates taking into consideration social contexts, alternative
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conceptualizations of mental health and disorders and difficulties, and
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what constitutes appropriate helpful interventions for psychological
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distress. Practitioner points
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Upskilling therapists to work with diversity and difference is essential
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for effective delivery of psychological treatments. Increasing the
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availability of culturally-adapted interventions together with
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therapists who are sufficiently competent and confident to deliver them
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should enable practitioners to work with a range of individuals with
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whom they might have little in common. Coproducing culturally
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appropriate means of responding to mental health difficulties, staff
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training and development, and service evaluation methods with clients
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necessitates taking into consideration social contexts, alternative
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explanatory models of mental health and `illness'', and what constitutes
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helpful interventions for psychological distress.'
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affiliation: 'Edge, D (Corresponding Author), Univ Manchester, Sch Hlth Sci, Fac Biol
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Med \& Hlth, Div Psychol \& Mental Hlth, Oxford Rd, Manchester M13 9PL, Lancs, England.
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Edge, Dawn; Lemetyinen, Henna, Univ Manchester, Sch Hlth Sci, Fac Biol Med \& Hlth,
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Div Psychol \& Mental Hlth, Oxford Rd, Manchester M13 9PL, Lancs, England.
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Edge, Dawn, Greater Manchester Mental Hlth NHS Trust, Res \& Innovat, Manchester,
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Lancs, England.'
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author: Edge, Dawn and Lemetyinen, Henna
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author-email: dawn.edge@manchester.ac.uk
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author_list:
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- family: Edge
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given: Dawn
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- family: Lemetyinen
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given: Henna
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da: '2023-09-28'
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doi: 10.1111/papt.12229
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eissn: 2044-8341
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files: []
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issn: 1476-0835
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journal: PSYCHOLOGY AND PSYCHOTHERAPY-THEORY RESEARCH AND PRACTICE
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keywords: 'cultural adaptation; cultural competence; culture; disparities;
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ethnicity; global mental health; psychological care'
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keywords-plus: 'GLOBAL MENTAL-HEALTH; AFRICAN-CARIBBEAN PATIENTS; ETHNIC-MINORITY
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GROUPS; HELP-SEEKING; 1ST-EPISODE PSYCHOSIS; INTERNALIZED STIGMA; CARE
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PROFESSIONALS; NATIONAL-SURVEY; ILLNESS STIGMA; PUBLIC STIGMA'
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language: English
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month: JUN
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number: 2, SI
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number-of-cited-references: '124'
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pages: 261-276
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papis_id: 081980064b42d2aad5f6331d6329323d
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ref: Edge2019psychologycultures
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times-cited: '10'
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title: 'Psychology across cultures: Challenges and opportunities'
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type: Article
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unique-id: WOS:000465169400007
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usage-count-last-180-days: '2'
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usage-count-since-2013: '25'
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volume: '92'
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web-of-science-categories: Psychology, Clinical; Psychiatry; Psychology
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year: '2019'
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