Sumud as a framework for collective resilience: a systematic review of implications for transcultural psychiatry and psychotherapy

Background Resilience is increasingly understood as a dynamic, ecological process; however, prevailing psychiatric models continue to emphasize individual traits, thereby neglecting collective and culturally embedded forms of endurance. Sumud (Arabic: صمود), broadly translating as steadfastness, perseverance, and endurance, sustains identity, dignity, and daily life under chronic adversity across the Arab world and functions as a relational and ethical orientation. This review examines sumud as a resilience framework for transcultural psychiatry and psychotherapy. Aims To synthesize conceptualizations of sumud in relation to resilience, coping, and adaptation, and to evaluate implications for narrative, family-based, group, community-oriented, and arts-informed therapeutic approaches. Methods A PRISMA 2020-guided systematic narrative review was conducted. Four electronic databases (PubMed, Scopus, Web of Science, and Embase) were searched covering publications up to 1 June 2026. English-language studies were eligible if they explicitly examined sumud as a cultural, psychological, or collective construct with relevance to resilience, coping, or psychotherapy. Eligible publication types included qualitative, quantitative, and mixed-methods empirical studies; theoretical and conceptual papers; ethnographies; narrative analyses; and reviews. Data were thematically synthesized using a predefined extraction matrix. The review was registered with PROSPERO (CRD420261279052). Results Thirty-nine studies met the inclusion criteria. Descriptively sumud emerged as a multilevel, collective form of resilience enacted through family systems, intergenerational narratives, cultural practices, and institutional structures. Substantively, it supported meaning-making, emotional regulation, and identity continuity. Critically, ethical tensions and cumulative burdens were documented, particularly for women, caregivers, and professionals., and rigorously evaluated, sumud-informed psychotherapeutic interventions remain scarce, notwithstanding a general preference in mental health studies for social-ecological models and narrative, family-based, group, and arts-based therapeutic approaches. Conclusions Theoretically, sumud challenges individualistic psychiatric frameworks by offering a culturally embedded, collective model of resilience. Clinically, it urges clinicians to engage with patients’ narratives, relational worlds, and cultural practices, while remaining attentive to the costs of endurance. Prospectively, in the context of ongoing conflicts and humanitarian crises affecting parts of the Middle East and Gulf region, sumud warrants renewed scholarly and clinical attention for the development of culturally responsive, resilience-informed psychotherapies. Systematic review registration https://www.crd.york.ac.uk/prospero/ , identifier CRD420261279052.