Cognitive behaviour therapy for psychosis can be adapted for minority ethnic groups: A randomised controlled trial

Rathod, Shanaya; Phiri, Peter; Harris, Scott; Underwood, Charlotte; Thagadur, Mahesh; Padmanabi, Uma; Kingdon, David

doi:10.1016/j.schres.2012.11.007

Cited by 102 publications

(105 citation statements)

References 47 publications

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“…This review identified several types of effective interventions in trial designs, including adapted cognitive-behavioural treatments, 61,63,64 adapted psychotherapies more generally, 57,67,68 complex interventions that engage with social systems and stepped care, 57 different interviewing techniques like ethnographic and motivational interviewing, 67 behavioural activation within an adapted cognitive-behaviour paradigm, 68 and role adoption that included information and training for patients to make best use of their services and better use of encounters with professionals. 60,69 The telepsychiatry intervention 65 showed a favourable response in that patients were willing to pay more for it than the standard treatment, although there was not much evidence of advantage in term of symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…preparing patients beforehand for their expected role in a psychiatric therapy before they received a therapeutic intervention 60,69 2. enhancements of existing therapies in terms of technical content and attention to beliefs 57,61,62,64,68 3. influencing wider social systems before and during therapy 57,67 4. peer or professional to patient psychoeducation to encourage acceptability and effective use of therapy 52,66 5. communication training for professionals to partner better with families, and increase expectations 62 6. an audiovisual pre-therapy training to help patients make best use of the therapy, described as role induction 60 7. the ethnic matching of the psychiatrist to the patient, achieved through the use of telepsychiatry. 65 The various components of each intervention were subjected to thematic analysis in order to capture the proposed effective elements.…”

Section: Description Of Interventionsmentioning

confidence: 99%

“…57,61,62 Afuwape et al, 57 in an exploratory randomised trial, showed improved symptom improvement on the 28-item General Health Questionnaire, following a community-based intervention for black people with common mental disorders in London; this was delivered by flexible outreach from psychiatric services into community venues. The intervention used principles of cognitive-behavioural therapy (CBT), ethnically matched therapists, advocacy and mentoring, and rapid access.…”

Section: High-quality Trialsmentioning

confidence: 99%

“…Thus adapted CBT for several ethnic groups 61 worked as well as CBT adapted for a single ethnic group. 64 Service users reviewing the evidence were supportive of these.…”

Section: Adapted Cognitive-behavioural Therapymentioning

confidence: 99%

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Interventions designed to improve therapeutic communications between black and minority ethnic people and professionals working in psychiatric services: a systematic review of the evidence for their effectiveness

Bhui

Aslam

Palinski

et al. 2015

Health Technology Assessment

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BackgroundBlack and minority ethnic (BME) people using psychiatric services are at greater risk of non-engagement, dropout from care and not receiving evidence-based interventions than white British people.ObjectivesTo identify effective interventions designed to improve therapeutic communications (TCs) for BME patients using psychiatric services in the UK, to identify gaps in the research literature and to recommend future research.ParticipantsBlack African, black Caribbean, black British, white British, Pakistani and Bangladeshi patients in psychiatric services in the UK, or recruited from the community to enter psychiatric care. Some studies from the USA included Hispanic, Latino, Chinese, Vietnamese, Cambodian and African American people.InterventionsAny that improve TCs between BME patients and staff in psychiatric services.Data sourcesThe published literature, ‘grey’ literature, an expert survey, and patients' and carers’ perspectives on the evidence base. Databases were searched from their inception to 4 February 2013. Databases included MEDLINE, Applied Social Sciences Index and Abstracts, The Cochrane Library, Social Science Citation Index, Allied and Complementary Medicine Database, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, EMBASE, The Campbell Collaboration and ProQuest for dissertations.Review methodsStudies were included if they reported evaluation data about interventions designed to improve therapeutic outcomes by improving communication between BME patients and psychiatric professionals. Qualitative studies and reports in the grey literature were included only if they gave a critical evaluative statement. Two members of the team selected studies against pre-established criteria and any differences were resolved by consensus or by a third reviewer, if necessary. Data were extracted independently by two people and summarised in tables by specific study designs. Studies were subjected to a narrative synthesis that included a thematic analysis contrasting populations, countries and the strength of evidence for any intervention. The components of the interventions were compared. Patient perspectives on acceptability were considered alongside quality scores and methodological strengths and weaknesses.ResultsTwenty-one studies (19 from the published literature and two from the grey literature) met the inclusion criteria. There were 12 trials, two observational quantitative studies, three case series, a qualitative study and three descriptive case studies. Only two studies, one a pilot trial and one a case series, included economic data; in both, a favourable but weak economic case could be made for the intervention. The trials tested interventions to prepare patients for therapeutic interventions, variable levels of ethnic matching (of professional to patient), cultural adaptation of therapies, and interventions that included social community systems in order to facilitate access to services. Empowering interventions favoured by patients and carers included adapted cognitive–behavioural therapy, assessments of explanatory models, cultural consultation, ethnographic and motivational interviews, and a telepsychiatry intervention.LimitationsStudies tended to have small sample sizes or to be pilot studies, and to use proxy rather than direct measures for TCs.ConclusionsEmpowering interventions should be further researched and brought to the attention of commissioners. Several promising interventions need further evaluative research and economic evaluations are needed.Study registrationThe study is registered as PROSPERO CRD42011001661.FundingThe National Institute for Health Research Health Technology Assessment programme.

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Section: Discussionmentioning

confidence: 99%

Section: Description Of Interventionsmentioning

confidence: 99%

Section: High-quality Trialsmentioning

confidence: 99%

“…Thus adapted CBT for several ethnic groups 61 worked as well as CBT adapted for a single ethnic group. 64 Service users reviewing the evidence were supportive of these.…”

Section: Adapted Cognitive-behavioural Therapymentioning

confidence: 99%

See 2 more Smart Citations

Interventions designed to improve therapeutic communications between black and minority ethnic people and professionals working in psychiatric services: a systematic review of the evidence for their effectiveness

Bhui

Aslam

Palinski

et al. 2015

Health Technology Assessment

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“…The influence of trauma and social factors, such as poverty or immigration status, have been demonstrated to be relevant to psychosis (20) and these are key foci in CBT (21), with success shown in cultural adaptations (22).…”

Section: Schizophrenia and Related Psychotic Disordersmentioning

confidence: 99%

The promise of cognitive behavior therapy for treatment of severe mental disorders: a review of recent developments

Thase

Kingdon

Turkington³

2014

Self Cite

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Cognitive behavior therapy (CBT), as exemplified by the model of psychotherapy developed and refined over the past 40 years by A.T. Beck and colleagues, is one of the treatments of first choice for ambulatory depressive and anxiety disorders. Over the past several decades, there have been vigorous efforts to adapt CBT for treatment of more severe mental disorders, including schizophrenia and the more chronic and/or treatment refractory mood disorders. These efforts have primarily studied CBT as an adjunctive therapy, i.e., in combination with pharmacotherapy. Given the several limitations of state-of-the-art pharmacotherapies for these severe mental disorders, demonstration of clinically meaningful additive effects for CBT would have important implications for improving public health. This paper reviews the key developments in this important area of therapeutics, providing a summary of the current state of the art and suggesting directions for future research.

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Cultural Adaptation of Cognitive Behavioural Therapy

Rathod¹,

Kingdon²,

Pinninti³

et al. 2015

Cultural Adaptation of CBT for Serious Mental Illness

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Cognitive behaviour therapy for psychosis can be adapted for minority ethnic groups: A randomised controlled trial

Cited by 102 publications

References 47 publications

Interventions designed to improve therapeutic communications between black and minority ethnic people and professionals working in psychiatric services: a systematic review of the evidence for their effectiveness

Interventions designed to improve therapeutic communications between black and minority ethnic people and professionals working in psychiatric services: a systematic review of the evidence for their effectiveness

The promise of cognitive behavior therapy for treatment of severe mental disorders: a review of recent developments

Cultural Adaptation of Cognitive Behavioural Therapy

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