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‘It’s been quite a poor show’ – exploring whether practitioners working for Improving Access to Psychological Therapies (IAPT) services are culturally competent to deal with the needs of Black, Asian and Minority Ethnic (BAME) communities

Part of: Being an Anti-Racist CBT therapist

Published online by Cambridge University Press:  27 February 2023

Afsana Faheem Open the ORCID record for Afsana Faheem [Opens in a new window]
Afsana Faheem*
Affiliation:
Department of Psychology, University of Bath, Bath, UK
*
Email: af890@bath.ac.uk
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Abstract

Cultural competency is a core clinical skill. Yet, psychological therapists may be inadequately trained to deal with the needs of service users from Black, Asian and Minority Ethnic (BAME) backgrounds. This can lead to dissatisfaction with mental health services, disengagement from therapy, and poorer treatment outcomes when compared to the White British population. The aim of this study was to explore whether practitioners working for Improving Access to Psychological Therapies (IAPT) services are culturally competent to deal with the needs of diverse communities. Semi-structured interviews were carried out with a range of practitioners, from early career psychological wellbeing practitioners (PWPs) to senior cognitive behavioural therapists (n=16). Reflexive thematic analysis (RTA) was used to analyse the data, guided by a six-phase process to produce a robust pattern-based analysis. Overall, three themes were generated: (1) encountering cultural dissonance within therapy; (2) challenges in making cultural adaptations to therapy; and (3) identifying cultural competency needs. Out of sixteen participants, only nine therapists received one-day formal training throughout their therapeutic career, whilst seven reported receiving no cultural competence training at all. Overall, it appears that there is an urgent need and desire for therapists to be offered cultural competency training so that they can better serve BAME communities. Clinical implications and future recommendations are made.

Key learning aims

  1. (1) To briefly introduce cross-cultural theoretical models that may assist mental health professionals to think critically about Western notions of therapy and whether they are suited to the needs of ethnic minority communities.

  2. (2) To consider challenges IAPT practitioners encounter during therapy and identify examples of good practice.

  3. (3) To explore to what extent IAPT practitioners feel culturally competent to deal with the needs of BAME communities.

  4. (4) To encourage IAPT services and decision makers (e.g. training bodies and commissioners) to enhance cultural competence training so that practitioners can better serve ethnic minority communities.

Keywords

BlackAsian and Minority Ethnic (BAME)common mental health disorderscultural competenceImproving Access to Psychological Therapies (IAPT)mental healthpsychotherapy
Type
Original Research
Information
the Cognitive Behaviour Therapist , Volume 16 , 2023 , e6
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of British Association for Behavioural and Cognitive Psychotherapies

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References

Further reading

Beck, A., Naz, S., Brooks, M., & Jankowska, M. (2019). Improving Access to Psychological Therapies (IAPT) Black, Asian and Minority Ethnic service user positive practice guide. Retrieved from: https://www.babcp.com/files/About/BAME/IAPT-BAME-PPG-2019.pdf Google Scholar
Clegg, S., Heywood-Everett, S., & Siddiqi, N. (2016). A review of cultural competence training in UK mental health settings. British Journal of Mental Health Nursing, 5, 176–183.CrossRefGoogle Scholar
Hofstede, G. (2011). Dimensionalizing cultures: the Hofstede model in context. Online Readings in Psychology and Culture, 2, 8.CrossRefGoogle Scholar
Markus, H. R., & Kitayama, S. (1991). Culture and the self: implications for cognition, emotion, and motivation. Psychological Review, 98, 224.CrossRefGoogle Scholar

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