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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
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
Peter Phiri, Shanaya Rathod, Mustafa G Soomro, Research & Innovation, Southern Health NHS Foundation Trust, Southampton SO30 3JB, United Kingdom
Peter Phiri, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton SO17 1BJ, United Kingdom
Isabel Clarke, Department of Italk, Southern Health NHS Foundation Trust, Southampton SO50 9FH, United Kingdom
Lydia Baxter, Department of Italk Step 3, Southern Health NHS Foundation Trust, Southampton SO51 9FH, United Kingdom
Yu-Tian Zeng, Jian-Qing Shi, Xin-Yuan Tang, Department of Statistics and Data Science, Southern University of Science and Technology, Shenzhen 518055, Guangdong Province, China
Jian-Qing Shi, National Center for Applied Mathematics Shenzhen, Shenzhen 518055, Guangdong Province, China
Gayathri Delanerolle, Nuffield Department of Primary Health Care Science, University of Oxford, Oxford OX3 7JX, United Kingdom
Farooq Naeem, Centre for Addition and Mental Health, University of Toronto, Toronto ON M5S, Canada
Author contributions: Phiri P and Naeem F drafted the first draft manuscript; Phiri P, Clarke I and Baxter L modified manual; Phiri P, Zeng Y, Tang X, Soomro MG, and Shi JQ conducted the analysis; and all authors revised and approved the final manuscript for publication.
Institutional review board statement: The study was approved by the Health Research Authority London-Camden & Kings Cross Research Ethics Committee, reference number: 16/LO/1899.
Clinical trial registration statement: This study is registered at Southern Health NHS Foundation Trust, Research & Innovation Department. The Sponsor study number is SHT260-207772.
Informed consent statement: All participants gave informed consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The authors will consider sharing the dataset gathered upon request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Peter Phiri, BSc, PhD, RN, Academic Fellow, Director, Research & Innovation, Southern Health NHS Foundation Trust, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton SO30 3JB, United Kingdom. peter.phiri@southernhealth.nhs.uk
Received: August 24, 2022
Peer-review started: August 24, 2022
First decision: October 21, 2022
Revised: October 25, 2022
Accepted: November 30, 2022
Article in press: November 30, 2022
Published online: January 19, 2023
ARTICLE HIGHLIGHTS
Research background
Currently, cognitive behavioral therapy (CBT) is one of the most common interventions implemented to treat symptoms of psychopathology of various illnesses. Standardised CBT manuals may not be completely relevant to all populations for several reasons including cultural and psychosocial variations.
Research motivation
Culturally adapted CBT could be beneficial to individuals of minority ethnic backgrounds as the contextual relevance may elevate the therapeutic benefit. Hence, this paper proposes a CaCBT-based third-wave therapy manual based on the Comprehend, Cope and Connect model.
Research objectives
This study aimed to test the feasibility, acceptability and adherence of the proposed intervention within ethnic minority participants who are currently engaged in Improving Access to Psychological Therapies’ iTalk and Community Mental Health Team services that are part of the United Kingdom’s National Health Service.
Research methods
In order to test the intervention, an uncontrolled feasibility study was deployed with 32 participants. Various outcome measures were recorded at three time points (baselines, post-intervention, and 12-wk follow-up).
Research results
A repeated measures analysis of variance revealed significant improvements in symptoms across Hospital Anxiety and Depression Scale depression and anxiety scores as well as the Clinical Outcomes in Routine Evaluation total score and World Health Organization Disability Assessment Schedule 2.0 measures.
Research conclusions
The results of this feasibility study reported that the CaCBT-based third-wave therapy was effective. Our results also showed significant adherence and acceptability among minority ethnic participants. Moderate effect sizes were reported with high participant satisfaction levels although a wider clinical trial will be required to fully assess the efficacy and effectiveness of the manual in the future.
Research perspectives
It would be important to further explore a randomised controlled trial as well as its’ cost-effectiveness, overall benefit and scalability to a more diverse sample within the United Kingdom. This would aid in conducting wider global clinical trials to better understand the suitability of this adapted intervention.
