Can Cognitive Therapy Rating Scale (CTRS) be Used Across Cultures? Enhancing Cultural Relevance of CTRS

This study is examining whether a scale used to assess the quality of cognitive behavioral therapy (CBT) — called the Cognitive Therapy Rating Scale (CTRS) — can be fairly and accurately applied across different cultures, and whether it needs to be adapted for cultural relevance. **You may be eligible if...** - You are between 18 and 65 years old - You have at least 5 years of education - You have been screened by a primary care clinician and scored 8 or higher on the Hospital Anxiety and Depression Scale (meaning you have at least mild anxiety or depression symptoms) **You may NOT be eligible if...** - You have a substance use disorder (by DSM-5 criteria) - You have significant cognitive impairment, such as severe learning disability or dementia - You are currently experiencing an active psychotic episode, as determined by your primary care clinician Talk to your doctor to see if this trial is right for you.