A qualitative study to explore views of patients\u2019, carers\u2019 and mental health professionals\u2019 to inform cultural adaptation of CBT for psychosis (CBTp) in China

Li Zhang,Zhiling Liu,Weihui Li,Xudong Liu,Shanaya Rathod,Xuerong Luo,Melissa Hudson,Farooq Naeem,Zhipeng Liu,Yuhuan Xie,Bangshan Liu,Muhammad Ayub,David Kingdon,Fang Lin,Nusrat Husain

doi:10.1186/s12888-017-1290-6

Abstract

BackgroundThe evidence for effectiveness of Cognitive Behaviour Therapy (CBT) is robust and the national organizations in the United Kingdom and the United States recommend its use. It is not utilized to its full potential in low and middle-income countries. Adaptation of CBT treatment to the target culture may facilitate its uptake.This study explored views of patients with schizophrenia, their caregivers, and mental health professionals for the purpose of cultural adaptation of CBT.MethodThe project was conducted in a teaching hospital in China. Systematic content and question analysis were the techniques we used to analyse the data generated in a series of qualitative interviews (N 45) in China. After identification of emerging themes and categories we compared and contrasted the themes across different interviews recursively. Triangulation of themes and concepts was undertaken to compare further and contrast the data from the different participating groups.ResultsThis work highlighted the barriers in therapy as well as opportunities for use of CBT in that environment. Patients and their carers in China use a bio-psycho-spiritual-social model of illness. CBT is not commonly used to help those with schizophrenia in China.ConclusionsThis study will facilitate the therapists using CBT for people with psychosis in China. These results require to be tested in clinical trials.

Highlights

The evidence for effectiveness of Cognitive Behaviour Therapy (CBT) is robust and the national organizations in the United Kingdom and the United States recommend its use
The evidence to support the effectiveness of CBT for psychosis (CBTp) in Low & Middle-Income Countries (LAMIC) is emerging [1,2,3,4,5], but it is rarely available in these countries
While there is one report from China that CBT for psychosis works, the therapy was provided by expert therapists, and additional supervision was given to deal with cultural issues

Summary

Introduction

The evidence for effectiveness of Cognitive Behaviour Therapy (CBT) is robust and the national organizations in the United Kingdom and the United States recommend its use. Adaptation of CBT treatment to the target culture may facilitate its uptake. This study explored views of patients with schizophrenia, their caregivers, and mental health professionals for the purpose of cultural adaptation of CBT. The evidence to support the effectiveness of CBT for psychosis (CBTp) in Low & Middle-Income Countries (LAMIC) is emerging [1,2,3,4,5], but it is rarely available in these countries. There is a recent drive to make evidence-based therapies, CBT available instead of developing indigenous treatments, as

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Conclusion