Cultural adaptation of Cognitive Stimulation Therapy (CST) for Portuguese people with dementia

Objectives: Portugal is one of the most aged countries in the world and dementia is increasing among the Portuguese population. It is estimated to affect around 200,000 people in Portugal. There is a clear need for non-pharmacological interventions to ameliorate the symptoms of dementia and improve the quality of life. Cognitive Stimulation Therapy (CST), a worldwide well-known program developed in the United Kingdom (UK), is recognized as a cost-effective intervention, with benefits both in cognitive function and quality of life of people with mild to moderate dementia. We tested the feasibility and cultural appropriateness and adapted CST to Portuguese people with dementia. Methods: The Formative Method for Adapting Psychotherapy (FMAP) model for cultural adaptation was used. A focus group discussion with health professionals and caregivers provided the basis for cultural adaptation, as well as feedback from participants, caregivers, and facilitators after a pilot study. Results: Some modifications were required, especially related to linguistic issues, in 11 of the 14 CST sessions. The adapted program was found to be acceptable and enjoyable in a small sample of people with dementia in a rehabilitation context. Conclusions: CST seems feasible and culturally appropriate in Portugal. A systematically developed and culturally adapted manual is ready to be used in a large-scale implementation and validation of CST in Portugal. Clinical implications: CST is a valid program for the Portuguese culture, contributes to the availability of a structured and effective clinical intervention for PwD in Portugal and to the possibility of comparing programs across countries.