Shanaya Rathod

Using cognitive behaviour therapy with South Asian Muslims: Findings from the culturally sensitive CBT project

Abstract It has been suggested that cognitive behaviour therapy (CBT) needs adaptation for it to be effective for patients from collectivistic cultures, as currently CBT is underpinned by individualistic values. In prior studies we have demonstrated that CBT could be adapted for Pakistani patients in Southampton, UK, and for local populations in Pakistan. Findings from these studies suggest that CBT can be adapted for patients from collectivistic cultures using a series of steps. In this paper we focus on these steps, and the process of adapting CBT for specific groups. The adaptation process should focus on three major areas of therapy, rather than simple translation of therapy manuals. These include (1) awareness of relevant cultural issues and preparation for therapy, (2) assessment and engagement, and (3) adjustments in therapy. We also discuss the best practice guidelines that evolved from this work to help therapists working with this population. We reiterate that CBT can be adapted effectively for patients from traditional cultures. This is, however, an emerging area in psychotherapy, and further work is required to refine the methodology and to test adapted CBT.

Implementation of Integrated Care Pathways for Persons with Psychosis in Ontario, Canada: Barriers and Opportunities

Currently there is an emphasis on developing Integrated Care pathways for mental health problems. The concept of pathways draws heavily from principles of lean thinking and is therefore based on improving the efficiency of the system to provide quality services to persons with health problems. Development of pathways for schizophrenia, along with depression and dementia is high priority in Ontario, Canada. This is an exciting development, especially as this might trigger radical changes in the health system to improve the care of those with schizophrenia. As the pathways are fully developed in England, we have tried to highlight the issues that can facilitate or hinder the development and implementation of the pathways in Ontario, compared with England. Development of pathways offers unique opportunities, that might lead to substantial improvement in care of persons with psychosis.

A Brief Review of Key Models in Cognitive Behaviour Therapy for Psychosis

Cognitive behavioural therapy (CBT) was originally developed as a comprehensive theory for treating depression. It has, however, since been extensively used to treat a wide range of emotional and mental health problems and is now a plausible treatment of choice for schizophrenia and associated psychotic symptoms. This review highlights the different models of CBT used for treating psychosis. These models have varying background, theory and rationale. Overall, literature shows that there are several models and approaches available but an underlying factor shared by all is the centricity of collaborative empiricism and individual formulation of specific presentations, however this varies across models. These models begin to address the impact of culture on treatment of psychosis. That is, they begin to acknowledge that different cultures may have different interpretations of a psychotic presentation such as delusions. It is imperative that models such as those presented here begin to acknowledge cultural influences and take these into account during their formation. This will have an impact on the way psychosis is treated using CBT. By being receptive to this, it could aid the client-therapist relationship and thus the outcomes of treatment.