3.7 CST approaches in different countries

Aim

The present topic will describe the use of CST globally and how it can be adapted to different cultures.

Learning outcomes

By the end of this topic, you will:

• Have been informed about how CST works internationally,
• Gain an understanding on how to adapt CST to different cultures.

Introduction

CST is now used worldwide, and its manual has been adapted and translated into at least 34 countries, such as Australia, USA, South Africa, New Zealand, Germany, China, Japan, Canada, Denmark, Italy, Israel, Japan, India, and many others. As a result, an international CST Centre has recently been established at University College London (UCL) that includes all the aforementioned countries.

3.7.1 Adaption of CST to different cultures and languages

At first, CST was developed and implemented in the UK but after its success, it began to attract global attention. By keeping in mind the cultural differences in almost every country, in addition to the language barriers, it was deemed crucial for a framework to be created that could facilitate the adaptation of CST. Therefore, the research team at UCL set out to design guidelines that could inform the process of adapting and translating the CST content and structure without compromising on its effectiveness.

To date, the majority of frameworks that have been used to adapt therapies to different cultures have taken a ‘top-down’ theoretical approach, in which people with dementia and other service users are consulted as a preliminary step to uncover their ideas and opinions (eg, how dementia is perceived in their culture). This step is essential because it provides an early understanding of how CST can be catered toward the needs of service users in that specific country. This framework-theoretical approach (Formative Method for Adapting Psychotherapy) consists of five phases, which are described in Figure 6 ^[1,2].

Figure 6: The five phases of cognitive stimulation therapy adaptation guidelines ^[2]

3.7.2 International CST

Currently, CST is used in all of the following countries and the list is constantly growing: Australia, Brazil, Canada, Chile, Croatia, China, Denmark, Egypt, Germany, Greece, Hong Kong, India, Israel, Italy, Ireland, Indonesia, Japan, Malaysia, Nepal, the Netherlands, New Zealand, Nigeria, Norway, Philippines, Portugal, Russia, Singapore, South Africa, South Korea, Spain, Taiwan, Tanzania, Thailand, Turkey, and the United States. CST is especially relevant for developing countries because it provides an effective low-cost intervention to help improve cognition and QoL. Establishing the international CST centre at UCL has been a crucial step toward making CST widely available as the centre has been facilitating collaborations and knowledge exchange between more than 34 countries that are currently practicing CST.

Synopsis

Key points:

• The World Alzheimer’s Report 2014 recommends that CST should routinely be given to people with early-stage dementia around the world.
• CST can be used effectively in a variety of populations, retaining its effectiveness in clinical outcomes.