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Results of a qualitative study of patient, carer and clinician views on the experience of caring for individuals with psychosis in Pakistan

Published online by Cambridge University Press:  21 June 2023

Shanaya Rathod ,
Afzal Javed ,
Rehmina Iqbal ,
Ayaat Al-Sudani ,
Akansha Vaswani-Bye ,
Imran Haider  and
Peter Phiri Open the ORCID record for Peter Phiri [Opens in a new window]
Shanaya Rathod*
Affiliation:
Southern Health NHS Foundation Trust, Research & Innovation Department, Southampton, UK University of Portsmouth, Portsmouth, UK
Afzal Javed
Affiliation:
WPA Secretariat Geneva University Psychiatric Hospital, Geneva, Switzerland Hope Fountain House, Lahore, Pakistan
Rehmina Iqbal
Affiliation:
Hope Fountain House, Lahore, Pakistan
Ayaat Al-Sudani
Affiliation:
Southern Health NHS Foundation Trust, Research & Innovation Department, Southampton, UK
Akansha Vaswani-Bye
Affiliation:
Department of Psychiatry & Behavioural Sciences, University of Washington School of Medicine, USA
Imran Haider
Affiliation:
Hope Fountain House, Lahore, Pakistan
Peter Phiri
Affiliation:
Southern Health NHS Foundation Trust, Research & Innovation Department, Southampton, UK University of Southampton, Psychology Department, Faculty of Environmental and Life Sciences, UK
*
Corresponding author: Shanaya Rathod; Email: Shanaya.Rathod@southernhealth.nhs.uk
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Abstract

Cultural relevance is a core element of effective psychological interventions like cognitive behaviour therapy (CBT) or family intervention (FI), which can be considered Eurocentric. There have been few studies that have examined explanatory models of mental illness and its management in Pakistan to date. This study elicited patient- and carer-related health beliefs on psychosis including attributions to illness, and help-seeking behaviours to inform development of culturally sensitive treatment and improve outcomes in a unit in Lahore (Pakistan). The study group completed 45 semi-structured qualitative interviews at a mental health rehabilitation centre in Lahore. Data were analysed thematically using emerging themes and content analysis. Participants’ explanatory models for psychosis included religion or faith-driven beliefs, like previous wrong-doing and supernatural ideas such as black magic. Social factors that impacted families included high expectations, social stigma, and discriminations. Families first sought help from faith leaders and then medical or psychological sources of care. Participants had generally positive attitudes about their experience of psychological interventions.

Key learning aims

  1. (1) The need to consider cultural influences to ensure relevance of interventions like cognitive behaviour therapy (CBT) or family interventions (FI) in different countries.

  2. (2) The need for cultural adaptation of interventions like CBT and FI in different countries to make them accessible and acceptable.

  3. (3) When adapting therapy to a particular culture or country, recognizing the importance of engaging the local cultural population in the adaptation process.

Keywords

CarerCultural adaptationsCultureInterventionsFamilyMental healthPsychologyPsychosisSchizophrenia
Type
Original Research
Information
the Cognitive Behaviour Therapist , Volume 16 , 2023 , e17
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

Naeem., F., Phiri, P., Rathod, S., & Kingdon, D. (2010). Using CBT with diverse patients: Working with South Asian Muslims. In Mueller et al. (eds), Oxford Guide to Surviving as a CBT Therapist. Oxford: Oxford University Press.Google Scholar
Phiri, P., Clarke, I., Baxter, L., Elliot, K., Rathod, S., & Naeem, F. (2021). Culture Free CBT for Diverse Groups. doi: 10.5772/intechopen.93904 CrossRefGoogle Scholar
Rathod, S., Kingdon, D., Pinninti, N., Turkington, D., & Phiri, P. (2015). Cultural Adaptation of CBT for Severe Mental Illness: A Guide for Training and Practice. Wiley-Blackwell.CrossRefGoogle Scholar
Rathod, S., Phiri, P., & Naeem, F. (2019). An evidence-based framework to culturally adapt cognitive behaviour therapy. the Cognitive Behaviour Therapist, 12.CrossRefGoogle Scholar

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