Evaluation of a culturally adapted cognitive behavior therapy-based, third-wave therapy manual

Peter Phiri; Isabel Clarke; Lydia Baxter; Yu-Tian Zeng; Jian-Qing Shi; Xin-Yuan Tang; Shanaya Rathod; Mustafa G Soomro; Gayathri Delanerolle; Farooq Naeem

doi:10.5498/wjp.v13.i1.15

Evaluation of a culturally adapted cognitive behavior therapy-based, third-wave therapy manual

World J Psychiatry. 2023 Jan 19;13(1):15-35. doi: 10.5498/wjp.v13.i1.15.

Authors

Peter Phiri^{1

2}, Isabel Clarke³, Lydia Baxter⁴, Yu-Tian Zeng⁵, Jian-Qing Shi^{5

6}, Xin-Yuan Tang⁵, Shanaya Rathod¹, Mustafa G Soomro¹, Gayathri Delanerolle⁷, Farooq Naeem⁸

Affiliations

¹ Research & Innovation, Southern Health NHS Foundation Trust, Southampton SO30 3JB, United Kingdom.
² School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton SO17 1BJ, United Kingdom. peter.phiri@southernhealth.nhs.uk.
³ Department of Italk, Southern Health NHS Foundation Trust, Southampton SO50 9FH, United Kingdom.
⁴ Department of Italk Step 3, Southern Health NHS Foundation Trust, Southampton SO51 9FH, United Kingdom.
⁵ Department of Statistics and Data Science, Southern University of Science and Technology, Shenzhen 518055, Guangdong Province, China.
⁶ National Center for Applied Mathematics Shenzhen, Shenzhen 518055, Guangdong Province, China.
⁷ Nuffield Department of Primary Health Care Science, University of Oxford, Oxford OX3 7JX, United Kingdom.
⁸ Centre for Addition and Mental Health, University of Toronto, Toronto ON M5S, Canada.

Abstract

Background: Recommendations for psychotherapy have evolved over the years, with cognitive behavioral therapy (CBT) taking precedence since its inception within clinical guidelines in the United Kingdom and United States. The use of CBT for severe mental illness is now more common globally.

Aim: To investigate the feasibility and acceptability of a culturally adapted, CBT-based, third-wave therapy manual using the Comprehend, Cope, and Connect approach with individuals from a diverse population presenting to primary and secondary healthcare services.

Methods: A pilot study was used to assess the feasibility and acceptability of the manualised intervention. Outcome measures were evaluated at baseline, post-intervention and 12 wk-follow up. 32 participants with mental health conditions aged 20-53 years were recruited. Assessments were completed at three time points, using Clinical Outcomes in Routine Evaluation (CORE), Hospital Anxiety and Depression Scale (HADS), Bradford Somatic Inventory and World Health Organization Disability Assessment Schedule 2.0 (WHODAS). The Patient Experience Ques-tionnaire was completed post-treatment.

Results: Repeated measures of analysis of variance associated with HADS depression, F (2, 36) = 12.81, P < 0.001, partial η² = 0.42 and HADS anxiety scores, F (2, 26) = 9.93, P < 0.001, partial η² = 0.36; CORE total score and WHODAS both showed significant effect F (1.25, 18.72) = 14.98, P < 0.001, partial η² = 0.5. and F (1.29, 14.18) = 6.73, P < 0.001, partial η² = 0.38 respectively.

Conclusion: These results indicate the effectiveness and acceptability of the culturally adapted, CBT-based, third-wave therapy manual intervention among minoritized groups with moderate effect sizes. Satisfaction levels and acceptability were highly rated. The viability and cost-effectiveness of this approach should be explored further to support universal implementation across healthcare systems.

Keywords: Cognitive behavioral therapy; Comprehend; Connect; Cope; Culture; Ethnicity.