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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
Processing time: 141 Days and 15.1 Hours
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.
Core Tip: This study explores the relevance of a cultural cognitive behavioral therapy manual to manage mental health and wellbeing in primary and secondary care settings in the United Kingdom. Specificity and adaptability are key to demonstrating the relevance as well as the cost-effectiveness of mental health management approaches. Results show the effectiveness of the proposed intervention, with high levels of acceptability and participant satisfaction.
