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Preliminary Evaluation of Culturally Adapted CBT for Psychosis (CA-CBTp): Findings from Developing Culturally-Sensitive CBT Project (DCCP)

Published online by Cambridge University Press:  02 January 2014

Nazish Habib ,
Saima Dawood ,
David Kingdon  and
Farooq Naeem
Nazish Habib
Affiliation:
University of the Punjab, Lahore, Pakistan
Saima Dawood
Affiliation:
University of the Punjab, Lahore, Pakistan
David Kingdon
Affiliation:
Southampton University, UK
Farooq Naeem*
Affiliation:
Southampton University, UK
*
Reprint requests to Farooq Naeem, Southampton University, Southampton SO14 3ED, UK. E-mail: farooqnaeem@yahoo.com
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Abstract

Background: Cognitive Behaviour Therapy for Psychosis (CBTp) has a strong evidence base and is practised widely in the Western World. Psycho-social interventions, on the other hand, including Cognitive Behaviour Therapy (CBT) are hardly used in the low and middle income countries for psychosis. It has been suggested that adaptations in content, format and delivery are needed before CBT can be used outside the Western cultures. We describe preliminary evaluation of Culturally Adapted Cognitive Behaviour Therapy for Psychosis (CaCBTp) in in-patient settings in Lahore, Pakistan. Aims: We aimed to evaluate the efficacy of culturally adapted CBT for psychosis (CaCBTp) in Pakistan in a pilot project. Method: In a randomized controlled trial we tested CaCBTp against treatment as usual (TAU) in in-patient settings in Pakistan. Those diagnosed with schizophrenia according to the DSM-IV-TR, and who fulfilled the inclusion criteria, were recruited into the study. Patients (n = 42) were randomized into two equal groups, i.e. CaCBTp and TAU. Assessments were carried out both at the baseline and then at the end of the therapy by raters blind to the groupings. Psychopathology was measured using PANSS (Positive and Negative Syndrome Scale of Schizophrenia), PSYRATS (Psychotic Symptom Rating Scales), and the Insight Scale. Results: Patients receiving CaCBTp showed statistically significant improvement on measures of positive symptoms (p = .000), negative symptoms (p = .000), overall psychotic symptoms (p = .000), hallucinations (p = .000), delusions (p = .000) and insight (p = .000) at the end of the therapy. Conclusions: The CaCBTp was effective in reducing symptoms of psychosis and in improving insight in in-inpatient settings in Pakistan.

Keywords

Acute psychosispsychosisbehavioural therapyblack and ethnic minorityCBTcognitive behaviour therapy
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 43 , Issue 2 , March 2015 , pp. 200 - 208
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2014 

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References

Ahmer, S., Faruqui, R. and Aijaz, A. (2007). Psychiatric rating scales in Urdu: a systematic review. BMC psychiatry, 7, 59.Google Scholar
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR. Washington, DC: American Psychiatric Publishing, Inc.Google Scholar
Bach, P. and Hayes, S. C. (2001). The use of acceptance and commitment therapy to prevent the rehospitalization of psychotic patients: a randomized controlled trial. Journal of Consulting Clinical Psychology, 70, 1129–1139.Google Scholar
David, A., Buchanan, A., Reed, A. and Almeida, O. (1992). The assessment of insight in psychosis. The British Journal of Psychiatry, 161, 599–602.Google Scholar
Dury, V., Birchwood, M., Cochrane, R. and MacMillan, F. (1996). Cognitive therapy and recovery from acute psychosis: a controlled trial I. Impact on psychotic symptoms. British Journal of Psychiatry, 169, 593–601.Google Scholar
Farooq, S., Nazar, Z., Irfan, M., Akhter, J., Gul, E., Irfan, U., et al. (2011). Schizophrenia medication adherence in a resource-poor setting: randomised controlled trial of supervised treatment in out-patients for schizophrenia (STOPS). The British Journal of Psychiatry, 199, 467–472Google Scholar
Gaudiano, B.A. and Herbert, J. D. (2006). Acute treatment of inpatients with psychotic symptoms using Acceptance and Commitment Therapy: pilot results. Behaviour Research and Therapy. 44, 415–437.Google Scholar
Haddock, G., Tarrier, N., Morrison, A. P., Hopkins, R., Drake, R. and Lewis, S. (1999). A pilot study evaluating the effectiveness of individual inpatient cognitive-behavioural therapy in early psychosis. Social Psychiatry and Psychiatric Epidemiology, 34, 254–258. doi:10.1007/s001270050141Google Scholar
Haddock, G., McCarron, J., Tarrier, N. and Faragher, E. B. (1999). Scales to measure dimensions of hallucinations and delusions: The Psychotic Symptom Rating Scales (PSYRATS). Psychological Medicine, 29, 879–889. doi:10.1017/S0033291799008661Google Scholar
Hays, P. A. and Iwamasa, G. Y. (Eds.) (2006). Culturally Responsive Cognitive-Behavioral Therapy: assessment, practice, and supervision. Washington, DC: American Psychological Association.Google Scholar
Hofmann, S. G. (2006). The importance of culture in cognitive and behavioral practice. Cognitive and Behavioral Practice, 13, 243–245. doi:10.1016/j.cbpra.2006.07.001Google Scholar
Kay, S. R. (1991). Positive and Negative Syndromes in Schizophrenia: assessment and research (Vol. 5). Routledge. Retrieved from http://books.google.co.uk/books?hl=enandlr=andid=onyWf7MLhm4Candoi=fndandpg=PR5anddq=Positive+and+Negative+Syndrome+Scale+of+Schizophrenia+Kay,+1991andots=ra4PPjWcoCandsig=LyMYKt-fOpxviiaEUH8UWJeC-44Google Scholar
Kay, S. R., Fiszbein, A. and Opfer, L. A. (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13, 261.Google Scholar
Kingdon, D. and Turkington, D. (1994). Cognitive-Behavioral Therapy of Schizophrenia. Hove: Lawrence Erlbaum.Google Scholar
Kirmayer, L. J. (2006). Beyond the ‘New Cross-Cultural Psychiatry’: cultural biology, discursive psychology and the ironies of globalization. Transcultural Psychiatry, 43, 126–144.Google Scholar
Lewis, S., Tarrier, N., Haddock, G., Bentall, R., Kinderman, P., Kingdon, D., et al. (2002). Randomised controlled trial of cognitive-behavioural therapy in early schizophrenia: acute-phase outcomes The British Journal of Psychiatry, 181, s91–97Google Scholar
Naeem, F., Ayub, M., Gobbi, M. and Kingdon, D. (2009). Development of Southampton Adaptation Framework for CBT (SAF-CBT): a framework for adaptation of CBT in non-western culture. Journal of Pakistan Psychiatric Society. Retrieved 10 June 2012 from http://www.pakmedinet.com/15940Google Scholar
Naeem, F., Gobbi, M., Ayub, M. and Kingdon, D. (2010). Psychologists experience of cognitive behaviour therapy in a developing country: a qualitative study from Pakistan. International Journal of Mental Health Systems, 4, 2.Google Scholar
Naeem, F., Ayub, M., Kingdon, D. and Gobbi, M. (2012). Views of depressed patients in Pakistan concerning their illness, its causes, and treatments. Qualitative Health Research. doi:10.1177/1049732312450212Google Scholar
Naeem, F., Gobbi, M., Ayub, M. and Kingdon, D. (2009). University students’ views about compatibility of cognitive behaviour therapy (CBT) with their personal, social and religious values (a study from Pakistan). Mental Health, Religion and Culture, 12, 847–55. doi:10.1080/13674670903115226Google Scholar
Naeem, F., Habib, N., Gul, M., Khalid, M., Saeed, S., Farooq, S., et al. (2013). Development of culturally sensitive CBT for psychosis in Pakistan. Manuscript submitted for publication.Google Scholar
Naeem, F., Waheed, W., Gobbi, M., Ayub, M. and Kingdon, D. (2011). Preliminary evaluation of culturally sensitive CBT for depression in Pakistan: findings from Developing Culturally-sensitive CBT Project (DCCP). Behavioural and Cognitive Psychotherapy, 39, 165–173. doi:10.1017/S1352465810000822CrossRefGoogle ScholarPubMed
Nasr, T. and Kausar, R. (2009). Psychoeducation and the family burden in schizophrenia: a randomized controlled trial. Annals of General Psychiatry, 8, 17.Google Scholar
NICE (2009). Schizophrenia: core interventions in the treatment and management of schizophrenia in adults in primary and secondary care. NICE Clinical Guideline, 82. Available at www.nice.org.uk/CG82 [NICE Guideline]Google Scholar
Tarrier, N., Lewis, S., Haddock, G., Bentall, R., Drake, R., Kinderman, P., et al. (2004). Cognitive behavioural therapy in first-episode and early schizophrenia: 18-month follow-up of a randomised controlled trial. British Journal of Psychiatry, 184, 231–239.Google Scholar
Wykes, T., Steel, C., Everitt, B. and Tarrier, N. (2008). Cognitive behavior therapy for schizophrenia: effect sizes, clinical models, and methodological rigor. Schizophrenia Bulletin, 34, 523–537. doi:10.1093/schbul/sbm114Google Scholar
Zimmermann, G., Favrod, J., Trieu, V. H. and Pomini, V. (2005). The effect of cognitive behavioral treatment on the positive symptoms of schizophrenia spectrum disorders: a meta-analysis. Schizophrenia Research, 77, 1–9. doi:10.1016/j.schres.2005.02.018Google Scholar
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