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Cultural adaptation of cognitive behaviour therapy for depression: a qualitative study exploring views of patients and practitioners from India

Part of: Being an Anti-Racist CBT therapist

Published online by Cambridge University Press:  31 March 2022

Sayma Jameel ,
Manjula Munivenkatappa Open the ORCID record for Manjula Munivenkatappa [Opens in a new window] ,
Shyam Sundar Arumugham  and
K Thennarasu
Sayma Jameel
Affiliation:
Department of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore-560029, India
Manjula Munivenkatappa*
Affiliation:
Department of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore-560029, India
Shyam Sundar Arumugham
Affiliation:
Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore-560029, India
K Thennarasu
Affiliation:
Department of Biostatistics, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore-560029, India
*
*Corresponding author. Email: drmanjula71@gmail.com
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Abstract

Cognitive behaviour therapy (CBT) is an effective treatment for depression. However, culture can influence engagement and treatment efficacy of CBT. Several attempts have been made in Asian countries to develop a culturally adapted CBT for depression. However, research in the Indian context documenting the views on cultural influence of CBT is limited. The present study is an attempt to explore the views of patients and therapists in India by following an evidence-based approach that focuses on three areas for adaptation: (1) awareness of relevant cultural issues and preparation for therapy; (2) assessment and engagement; and (3) adjustments in therapy techniques. Semi-structured interviews with three consultant clinical psychologists/therapists, a focused group discussion with six clinical psychologists, and two patients undergoing CBT for depression were conducted. The data were analysed using a thematic framework analysis by identifying emerging themes and categories. The results highlight therapists’ experiences, problems faced, and recommendations in all three areas of adaptation. The findings highlight the need for adaptation with understanding and acknowledging the culture differences and clinical presentation. Culturally sensitive assessment and formulation with minor adaptation in clinical practice was recommended. Therapists emphasised the use of proverbs, local stories and simplified terminologies in therapy. The findings will aid in providing culturally sensitive treatment to patients with depression in India.

Key learning aims

  1. (1) To understand the views of Indian patients and therapists based on their experience of CBT.

  2. (2) To understand the need for cultural adaptation of CBT in India.

  3. (3) To understand the adaptations by therapists while using CBT in clinical practice.

  4. (4) To gain perspective on how CBT can be culturally adapted to meet the needs of the Indian population.

Keywords

cognitive behaviour therapycultural adaptationdepressiontherapist and patient views
Type
Original Research
Information
the Cognitive Behaviour Therapist , Volume 15 , 2022 , e16
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the British Association for Behavioural and Cognitive Psychotherapies

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References

Further reading

Naeem, F., Phiri, P., Nasar, A., Munshi, T., Ayub, M., & Rathod, S. (2016). An evidence-based framework for cultural adaptation of cognitive behaviour therapy: process, methodology and foci of adaptation. World Cultural Psychiatry Research Review, 11, 67–70 Google Scholar
Rathod, S., Kingdon, D., Pinninti, N., Turkington, D., & Phiri, P. (2015). Cultural Adaptation of CBT for Serious Mental Illness: A Guide for Training and Practice. Wiley Blackwell. https://doi.org/10.1002/9781118976159 CrossRefGoogle Scholar

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