LETTER TO THE EDITOR

Contextualizing Psychoeducational Methodologies in Rural Areas of Peru: An Urgent Complement from Realist Evaluation and Synthesis in Psychology

Walter Porras Tomasto ^1*

¹ Psychological Support, UGEL Andahuaylas, Apurímac, Peru.

* Correspondencia: walterporrastomasto@gmail.com

Received: September 23, 2025 | Reviewed: December 27, 2025 | Accepted: February 12, 2026 | Published Online: February 13, 2026.

CITARLO COMO:

Porras Tomasto, W. (2025). Contextualizing Psychoeducational Methodologies in Rural Areas of Peru: An Urgent Complement from Realist Evaluation and Synthesis in Psychology. Interacciones, 12, e482. http://dx.doi.org/10.24016/2026.v12.482

Dear Editor,

Mental health in rural areas of Peru continues to face a persistent methodological limitation: the implementation of standardized psychoeducational programs originally designed for urban, culturally homogeneous settings. Well-intentioned interventions confined to manuals are insufficient; they require cultural relevance and methodological rigor that explicitly consider context. In high Andean, Amazonian, or peri-urban territories, such proposals are often implemented without explicit adaptation of their cultural, linguistic, and relational assumptions. The problem is not the existence of programs, but their uncritical extrapolation. In these settings, cultural, linguistic, and affective diversity often becomes invisible to implementing professionals, who should ask: “Does it work, for whom, under what circumstances, and why?” (Argüelles & Harding, 2025). Therefore, we argue that without explicit cultural adaptation and a realist evaluation grounded in Context–Mechanism–Outcome (CMO) configurations, school-based psychoeducation in rural areas of Peru risks sustained ineffectiveness or cultural iatrogenesis.

International evidence indicates that psychoeducation tailored to specific contexts can significantly reduce emotional symptoms in adolescents (Kitchiner et al., 2019; Jordans et al., 2020). Despite these findings, in Peru there remains a significant gap in studies evaluating how these interventions function when implemented in culturally diverse rural contexts such as Apurímac, Puno, Huancavelica, or Loreto, where representations of psychological distress, trauma, family, and self-care differ from the classical Western cognitive-behavioral or biomedical framework (Espinoza & Quispe, 2022). The urgency lies not only in expanding community mental health coverage, but in ensuring that interventions operate according to the specific logics and life dynamics of vulnerable groups such as children and adolescents (WHO, 2023). The objective of this letter is to defend the relevance of realist evaluation and synthesis, as outlined in a previous editorial. We propose the use and appraisal of this methodology, as conceived by Pawson and Tilley (1997), as a rigorous tool to examine not only whether an intervention works, but also how, for whom, and under what conditions. In this way, greater intervention effectiveness can be achieved.

From this perspective, we propose three concrete actions for the field. First, every school-based psychoeducation program should explicitly state its CMO hypotheses before implementation or scaling up. Second, linguistic, cosmovisional, and community components should not be treated as decorative context, but as potential mechanisms to be empirically tested. Third, pilot programs should include participatory cultural validation prior to territorial expansion. These proposals are grounded in the premise that interventions analyzed according to the CMO model (Context–Mechanism–Outcome) can uncover the internal logics that explain why a program works in one setting and why it fails in another with similar demographic characteristics (Gilmore, 2019). In Peru, research applying this approach to psychoeducational programs in high Andean or Amazonian schools remains limited. Therefore, implementing this realist model would enable the design of collaborative pilot experiences in which stakeholders themselves (teachers, health promoters, students, mothers, and fathers) co-construct meaningful adaptations grounded in their daily practices.

To illustrate this perspective, in urban contexts, “self-care” is often taught through emotional self-regulation and verbal expression. In many Quechua communities, however, this concept is linked to reciprocity, the “minka,” care for the environment, and collective spirituality. These differences are rarely considered in conventional psychoeducational sessions. A well-intentioned intervention that fails to acknowledge these particularities may generate rejection, indifference, or, worse, an implicit message of cultural invalidation, resulting in limited effectiveness. This also helps explain why an intervention succeeds in one setting and fails in another. From a community intervention perspective, it is urgent to incorporate mixed methods: quantitative approaches to measure impact and qualitative approaches to interpret meaning. This position is supported by the RAICES community (2025), which promotes realist evaluation and synthesis as a bridge between scientific evidence, local knowledge, and worldviews. Similarly, initiatives such as those of the MINSA (2023) to strengthen community mental health should incorporate cultural validation, participatory design, and linguistic adaptation into their pilot programs.

Regarding rural adolescence, research by Mendoza and Quiroz (2023) has shown that strengthening emotional skills in schoolchildren is enhanced when content is conveyed through traditional narratives, collective games, local songs, and intergenerational trust spaces. These are tools already used in psychology; however, their integration often fails to acknowledge the richness of local worldviews. Such practices are frequently marginalized in more structured intervention designs funded by centralized or external agencies. The aim is not to oppose popular knowledge to psychological science, but to integrate and adapt both in order to foster identification and, consequently, greater intervention effectiveness. Therefore, the intercultural approach in mental health should cease to function as a discursive annex and instead become an evaluable and transversal component. In this regard, the academic community, specialized journals, early-career researchers, and knowledge networks play a key role in creating space for innovative methodologies that are consistent with Peru’s complexity and diversity.

This letter proposes, first, urging psychologists who implement mental health interventions in school populations to promote psychoeducational methodologies grounded in lived experience and contextual complexity while maintaining scientific rigor. Second, it seeks to complement a previous editorial note and to call upon researchers, academics, and contributors to scientific knowledge to prioritize studies grounded in realist and cosmovisional psychology. Their contributions should not be limited to urban populations, nor should rural areas be reduced to risk data and statistics. If psychoeducation in rural areas aims to be scientifically rigorous and ethically relevant, it must demonstrate not only that it works on average, but how and under what cultural configurations it produces sustainable effects. Realist evaluation is not an optional complement; it is a methodological condition for preventing the invisibilization of Peruvian diversity in applied psychological research.

ORCID

Walter Porras Tomasto: https://orcid.org/0000-0002-8384-4369

AUTHORS’ CONTRIBUTION

Walter Porras Tomasto: Conceptualization, writing original draft, reviewing and editing.

FUNDING SOURCE

This paper has been self-financed.

CONFLICT OF INTEREST

The authors declare no conflict of interest.

ACKNOWLEDGMENTS

Not applicable.

REVIEW PROCESS

This study has been reviewed by external peers in double-blind mode. The editor in charge was David Villarreal-Zegarra. The review process is included as supplementary material 1.

DATA AVAILABILITY STATEMENT

Not applicable

DECLARATION OF THE USE OF GENERATIVE ARTIFICIAL INTELLIGENCE

DeepL was used to translate specific sections of the manuscript. Grammarly was used to review and improve the wording of certain sections. The final version of the manuscript was reviewed and approved by the authors.

DISCLAIMER

The authors are responsible for all statements made in this article.

REFERENCES

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