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A Qualitative Study to Explore Patients’, Carers’ and Health Professionals’ Views to Culturally Adapt CBT for Psychosis (CBTp) in Pakistan

Published online by Cambridge University Press:  02 September 2014

Farooq Naeem ,
Nazish Habib ,
Mirrat Gul ,
Mehwish Khalid ,
Sofiya Saeed ,
Saeed Farooq ,
Tariq Munshi ,
Mary Gobbi ,
Nusrat Husain  and
Muhammad Ayub
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Farooq Naeem*
Affiliation:
Queens University, Kingston, Ontario, Canada
Nazish Habib
Affiliation:
Sir Ganga Ram Hospital at Lahore, Pakistan
Mirrat Gul
Affiliation:
Sir Ganga Ram Hospital at Lahore, Pakistan
Mehwish Khalid
Affiliation:
Pakistan Association of Cognitive Therapists (PACT), Pakistan
Sofiya Saeed
Affiliation:
Pakistan Association of Cognitive Therapists (PACT), Pakistan
Saeed Farooq
Affiliation:
Staffordshire University, UK
Tariq Munshi
Affiliation:
Queens University, Kingston, Ontario, Canada
Mary Gobbi
Affiliation:
Southampton University, UK
Nusrat Husain
Affiliation:
Manchester University, UK
Muhammad Ayub
Affiliation:
Queens University, Kingston, Ontario, Canada
David Kingdon
Affiliation:
Southampton University, UK
*
Reprint requests to Farooq Naeem, Associate Professor, Department of Psychiatry, Queens University, Kingston, Ontario, Canada. E-mail: farooqnaeem@yahoo.com
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Abstract

Background: Cognitive Behaviour Therapy (CBT) has an established evidence base and is recommended by the national organizations in United Kingdom and the United States. CBT remains under utilized in low and middle income countries. CBT was developed in the west and it has been suggested that it is underpinned by western values. It therefore follows that to make CBT accessible for non western clients, it needs adapting into a given culture. Aims: Our aim was to develop guidelines for adapting CBT for psychosis in Pakistan by incorporating the views of the patients, their carers and mental health professionals. Method: We conducted a series of qualitative studies in Pakistan to adapt CBT for psychosis (a total of 92 interviews). The data were analyzed by systematic content and question analysis. Analysis started by identifying emerging themes and categories. Themes emerging from the analyses of interviews by each interviewer were compared and contrasted with others interviewers constantly. Triangulation of themes and concepts was undertaken to further compare and contrast the data from the different participating groups. Results: The results of these studies highlighted the barriers in therapy as well as strengths while working with this patient group. Patients and their carers in Pakistan use a bio-psycho-spiritual-social model of illness. They seek help from various sources. Therapists make minor adjustments in therapy. Conclusions: The findings from this study will help therapists working with this client group using CBT for psychosis in Pakistan. These results need to be tested through controlled trials.

Keywords

Cultureadaptationcognitive therapypsychosisschizophreniaPakistan
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 44 , Issue 1 , January 2016 , pp. 43 - 55
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2014 

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Footnotes

Supplementary material is also available online in the table of contents for this issue: http://journals.cambridge.org/jid_BCP

References

Atkinson, P. A., Delamont, S., Coffey, A. J., Lofland, J. and Lofland, L. H. (Eds.) (2007). Handbook of Ethnography. London: Sage Publications.Google Scholar
Creswell, J. W. (2009). Research Design: qualitative, quantitative, and mixed methods approaches. London: Sage Publications.Google Scholar
Furnham, A., Raja, N. and Khan, U. A. (2008) A cross-cultural comparison of British and Pakistani medical students’ understanding of schizophrenia. Psychiatry Research, 30, 308–319.Google Scholar
Habib, N., Dawood, S., Kingdon, D. and Naeem, F. (2014). Preliminary evaluation of culturally adapted CBT for psychosis (CA-CBTp): findings from developing culturally-sensitive CBT project (DCCP). Behavioural and Cognitive Psychotherapy. doi:10.1017/S1352465813000829 Google Scholar
Hammersley, M. and Atkinson, P. (1994). Ethnography: principles in practice (2nd ed.). London: Routledge.Google Scholar
Hays, P. A. and Iwamasa, G. Y. (2006). Culturally Responsive Cognitive-Behavioral Therapy: assessment, practice, and supervision. Washington, DC: American Psychological Association.Google Scholar
Iwamasa, G. Y. (1993). Asian Americans and cognitive behavior therapy. The behaviour Therapist, 16, 233–235.Google Scholar
Joel, D., Sathyaseelan, M., Jayakaran, R., Vijayakumar, C., Muthurathnam, S. and Jacob, K. S. (2003). Explanatory models of psychosis among community health workers in South India. Acta Psychiatrica Scandinavica, 108, 66–69.Google Scholar
Jorgensen, D. L. (1989). Participant Observation: a methodology for human studies. London: SAGE.Google Scholar
Kvale, S. (1996). Interviews: an introduction to qualitative research interviewing. Thousand Oaks, CA: Sage.Google Scholar
Kleinman, A. (1980). Patients and Healers in the Context of Culture: an exploration of the borderland between anthropology, medicine, and psychiatry. Berkeley, CA: University of California Press.Google Scholar
Littlewood, R. (1990). From categories to contexts: a decade of the “new cross-cultural psychiatry”. The British Journal of Psychiatry, 156, 308–327 Google Scholar
Lloyd, K. R., Jacob, K. S., Patel, V., St Louis, L., Bhugra, D. and Mann, A. H. (1998). The development of the Short Explanatory Model Interview (SEMI) and its use among primary-care attenders with common mental disorders. Psychological Medicine, 28, 1231–1237.Google Scholar
Morse, J. M. and Field, P. A. (1996). Nursing Research: the application of qualitative approaches. Cheltenham: Stanley Thornes.Google 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, 6, 79–84.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, 22, 1083–1093.CrossRefGoogle ScholarPubMed
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, 847–855.Google Scholar
Naeem, F., Phiri, P., Rathod, S. and Kingdon, D. (2010). Using CBT with diverse patients. Working with South Asian Muslims. In The Oxford Guide to Surviving as a CBT Therapist (pp. 55, 41). Oxford: Oxford University Press.Google Scholar
Naeem, F., Ayub, M., McGuire, N. and Kingdon, D. (2010). Culturally Adapted CBT (CaCBT) for Depression: therapy manual. Lahore: Pakistan Association of Cognitive Therapists.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 Google Scholar
Weiss, M. (1997). Explanatory Model Interview Catalogue (EMIC): framework for comparative study of illness. Transcultural Psychiatry, 34, 235–263.Google Scholar
Wong, D. F. K. (2008). Cognitive behavioral treatment groups for people with chronic depression in Hong Kong: a randomized wait-list control design. Depression and Anxiety, 25, 142–148.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/sbm114 Google Scholar
Zafar, S. N., Syed, R., Tehseen, S., Gowani, S. A., Waqar, S., Zubair, A., et al. (2008). Perceptions about the cause of schizophrenia and the subsequent help seeking behavior in a Pakistani population: results of a cross-sectional survey. BMC Psychiatry, 8, 56.Google Scholar
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