Research

Psychologists experience of cognitive behaviour therapy in a developing country: a qualitative study from Pakistan

Farooq Naeem¹ , Mary Gobbi² , Muhammad Ayub³ and David Kingdon⁴

¹  Lahore Institute of Research and Development, Lahore, Pakistan

²  Medicine, Health and Life Sciences, University of Southampton, Southampton, UK

³  Psychiatry of Learning Disability, Tees Esk & Wear Valley NHS Foundation Trust, Darlington, Durham, UK

⁴  University Department of Psychiatry, Royal South Hants Hospital, Southampton, UK

author email corresponding author email

International Journal of Mental Health Systems 2010, 4:2doi:10.1186/1752-4458-4-2

Published:	28 January 2010

Abstract

Background

Psychological therapies especially Cognitive Behaviour Therapy (CBT) are used widely in the West to help patients with psychiatric problems. Cognitive Behaviour Therapy has an established evidence base for the treatment of different emotional disorders. In spite of these developments in the developed world, patients in most developing countries hardly benefit from non pharmacological interventions. Although a significant number of psychologists are trained in Pakistan each year, psychological interventions play only a minor role in treatment plans in Pakistan. We conducted interviews with psychologists in Pakistan, to explore their experiences and their views on "providing CBT in Pakistan". These interviews were conducted as part of a project whose focus was to try to develop culturally-sensitive CBT in Pakistan.

Methods

In depth semi structured interviews were conducted with 5 psychologists working in psychiatry departments in Lahore, Pakistan.

Results

All the psychologists reported that psychotherapies, including CBT, need adjustments for use in Pakistan, although they were not able to elicit on these in details. Four major themes were discovered, hurdles in therapy, therapy related issues, involvement of the family and modification in therapy. The biggest hurdles in therapy were described to be service and resource issues.

Conclusions

For CBT to be acceptable, accessible and effective in Non Western cultures numerous adjustments need to be made, taking into consideration; factors related to service structure and delivery, patient's knowledge and beliefs about health and the therapy itself. Interviews with the psychologists in these countries can give us insights which can guide development of therapy and manuals to support its delivery.