The cultural adaptation of mindfulness-based cognitive therapy for older adults with depression in Indonesia

Abstract

Despite its global recognition, Mindfulness Based Cognitive Therapy (MBCT) remains under-explored in terms of cultural adaptation and effectiveness among older adults in non-Western contexts such as Indonesia, where depression is both prevalent and shaped by cultural perceptions. This study presents a culturally adapted MBCT approach for older Indonesians with depression to enhance its relevance, acceptability, and therapeutic efficacy. The adaptation process utilised a systematic methodology grounded in the FMAP (Formative Method of Adapting Psychotherapy) as a multistep therapeutic adaptation procedure, and the PAMF (Psychotherapy Adaptation and Modification Framework) facilitated the identification of places suitable for adaptation to enhance the legitimacy of these alterations. The modified intervention was tested with a cohort of eight older adults, and qualitative feedback was gathered to evaluate its acceptability and efficacy. Initial findings indicate that the culturally adapted MBCT programme was well received, as demonstrated by high attendance rates and low attrition, highlighting its practicality and acceptance within this community. The study emphasises the importance of cultural sensitivity in mental health interventions. It also provides recommendations for future research, advocating for larger randomised controlled trials to validate the findings and further refine the cultural adaptation and implementation of MBCT for older population.