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Acceptance and commitment therapy (ACT) is a cognitive-behavioral therapy widely used to treat psychological problems. Meta-analytic studies have focused on treatment outcomes; however, few systematic reviews have analyzed how ACT is adapted to suit different cultures. Several frameworks were developed to evaluate cultural adaptations of psychological treatments. The ecological validity framework assesses cultural adaptations of psychotherapies. The model consists of dimensions evaluating how an intervention is adapted to be culturally sensitive. This framework explores how a psychotherapy treatment is adapted for other cultures by using and/or changing language, client-therapist match (persons), metaphors, content, concepts, goals, methods, and context.
As cultural differences play a vital role in the efficacy of psychotherapy interventions, the current study will investigate the cultural adaptations of ACT for non-Western populations using a systematic review. My research will highlight the different components of the EVF that ACT has been adapted to. This research will systematically extract studies that have applied an ACT protocol to a non-western population and have explicitly mentioned a cultural adaptation. This will also showcase where ACT’s cultural adaptations stand and where we might want to work to improve. From an initial look at the studies in my sample, it seems that some interventions mainly adapted the language component. At the same time, others made more comprehensive adaptations not only for the language but also for content, context, metaphors, and methods. Investigating cultural adaptations for psychotherapies is necessary as there is a need to tailor treatments to suit the client seeking help.

Over half of the college students have experienced some level of suicidal ideation in their lifetime, and out of those, approximately 7.7% have attempted suicide (Dueweke & Schwartz-Mette, 2017). International students have been shown to have higher suicide attempt rates despite lower reported diagnoses of depression and anxiety (Yeung et al.  2022). International graduate and undergraduate students face various obstacles when adjusting to a new culture and educational system.  Stressors such as cultural, academic, and language adjustments, as well as visa and legal concerns, can contribute to heightened risks of depression, distress, and suicidal ideation (Chen et al., 2020; Forbes-Mewett & Sawyer, 2019). For example, Pérez-Rojas et al. (2024) found that discrimination, academic stress, and cultural disconnection can contribute to feelings of perceived burdensomeness, which has been associated with suicide ideation. Additionally, limited support systems and difficulties in forming social connections further complicate the experience of international undergraduate and graduate students (Poyrazli & Lopez, 2020). The current paper is a systematic review that explores the key factors contributing to suicidal behavior among international students in higher education. The review will focus on critical factors including academic distress, social difficulties, and cultural adaptation. Preliminary findings suggest that relationship problems and academic stress are the most prevalent predictors of suicidality in this group. The study will provide recommendations for assessing and managing suicide ideation within the international student community.

The biosocial model of borderline personality disorder (BPD) was developed by Linehan (1993) as a method of conceptualizing the experience of individuals diagnosed with BPD while also providing a guide for treatment planning. The biosocial model is a transactional model balancing two key components including a biological vulnerability to intense emotions and exposure to an emotionally invalidating environment. Empirical evidence has largely provided support for the biological element of the treatment (Kuo, 2009) as well as elements of the invalidating environment.  One, understudied, area of analysis is the role of rejection sensitivity in the biosocial model. Rejection sensitivity can be defined as the percipiency to expect and respond to cues of interpersonal rejection (Preti et al., 2020).  Individuals who experience higher levels of rejection sensitivity tend to anticipate and experience increased levels of interpersonal rejection (Chaudoir et al., 2017). In the biosocial model, rejection sensitivity can be conceptualized as a consequence of the two core elements of the biosocial model.  The goal of the present study was to examine the association between the two elements of the biosocial model along with rejection sensitivity as they relate to borderline symptoms.  It was predicted that the effect of the invalidating environment on borderline symptoms would be increased when participants scored higher on rejection sensitivity. The results will be discussed in the context of the need for further replication and extension in clinical populations and across diverse populations.