Adaptation of a Preventive Intervention Approach to Strengthen Families Facing Adversities, Especially Depression. Costa Rica: Initial Systems Approaches and a Case Example

Abstract

This paper describes the first phase in the adaptation of an evidence-based preventive intervention for eventual widespread use in Costa Rica. With systematic support for adaptation of the intervention from the Caja Costarricense del Seguro Social (CCSS) and its Department of Mental Health, a group of clinicians from Costa Rica and Boston, Massachusetts, met regularly twice a year for three years to explore how the intervention could be adapted and made most useful in Costa Rica. It proved possible to adapt the intervention successfully in several settings. Important contributory factors were that the preventive intervention was a public health intervention designed to be used by a wide range of practitioners, that it included the family as a whole in a strength-based preventive framework, that there was strong, central administrative support, and that Costa Rican clinicians were given time and support to adapt the intervention flexibly in various settings. Greater attention should be given to adapting evidence-based preventions in different countries.

Keywords:

• PARENTAL DEPRESSION
• FAMILY CENTERED PREVENTIVE INTERVENTION
• COSTA RICA