Culturally adapted Family Intervention (CaFI): case examples from therapists’ perspectives

Berry, Katherine; Day, Christine; Mulligan, Lee D.; Seed, Tara; Degnan, Amy; Edge, Dawn

doi:10.1017/s1754470x18000156

Cited by 5 publications

(6 citation statements)

References 22 publications

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“…Despite this constraint, family-based intervention was still recommended by all included studies because of its cited effectiveness in individual studies, primarily in symptom reduction and improved family dynamics. A majority of the studies also reported decreased relapse rate, consistent with the evidence from HICs [ 33 , 53 , 83 ]. Additionally, patient outcomes related to decreased EE [ 20 , 22 , 84 ] that have been observed in HICs were also evident in the LMICs.…”

Section: Discussionsupporting

confidence: 78%

Exploring the effectiveness of family-based interventions for psychosis in low- and middle-income countries: a systematic review

Morillo

Lowry

Henderson

2022

Soc Psychiatry Psychiatr Epidemiol

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Purpose Of the 80% people with psychosis living in low- and middle-income countries (LMICs), up to 90% are left to the care of families. The World Health Organization has recommended the inclusion of families in community-based rehabilitation and while there is evidence of its implementation in LMICs, this has not been reviewed yet. This study aims to describe the key features and implementation strategies of family-based interventions in LMICs, and appraise their effectiveness. Methods Included are people with psychosis in LMICs who receive any form of family-based intervention, compared to their usual or absence of treatment, with patient outcome measures. We searched (August 2021) through Embase, MEDLINE, Global Health, PsycInfo, Social Policy and Practice, and Cumulative Index to Nursing and Allied Health Literature (CINAHL), as well as from grey literature and hand-searched records. Risk of bias was assessed through the Integrated Quality Criteria for Review of Multiple Study Designs (ICROMS) and Consolidated Health Economic Evaluation Reporting Standards (CHEERS), then analyzed narratively. Results 27 studies were included from the 5254 records. Psychotherapeutic features, systems approach and task-sharing were key intervention elements. Delivery strategies included preliminary research, sustained family engagement, and cultural adaptation. There were positive health impacts across four outcome domains. Conclusion All studies recommended family-based interventions, with limitations in heterogeneity and 70% of them rated high risk of bias. Other Review was registered in PROSPERO (CRD42021256856). The authors did not receive funding for this research.

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Section: Discussionsupporting

confidence: 78%

Exploring the effectiveness of family-based interventions for psychosis in low- and middle-income countries: a systematic review

Morillo

Lowry

Henderson

2022

Soc Psychiatry Psychiatr Epidemiol

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“…(b) Cultural adaptation of therapies for a diverse population Culturally adapted Family Intervention (CaFI): case examples from therapists' perspectives (Berry et al, 2018) These authors pioneered cultural adaptation of a CBT-based family intervention for psychosis for African-Caribbean people in England, and found it to be feasible and acceptable (Edge et al, 2018a,b). This paper reports on the process of culturally adapted family intervention from a therapist's perspective.…”

Section: Summary and Discussionmentioning

confidence: 99%

“…There is (a) one systematic review of CBT for social anxiety among the culturally diverse population (Jankowska, 2019). There are (b) seven articles covering different aspects of adaptation of therapies for diverse populations which include: culturally adapted family intervention using case studies (Berry et al , 2018), a discussion of maladaptive schema and schema therapy in the context of Greek culture (Kolonia et al , 2019), use of a transdiagnostic intervention in low resource countries (Murray et al , 2019), application of acceptance and commitment therapy (ACT) with a Turkish population in London (Perry et al , 2019), a framework to culturally adapt CBT (Rathod et al , 2019), a case report of family-based CBT for obsessive compulsive disorder (OCD) from Saudi Arabia (Alatiq and Alrshoud, 2018) and a paper discussing CBT in military culture (Zwiebach et al , 2019). Three papers (c) address the issues of gender and sexuality.…”

Section: Summary and Discussionmentioning

confidence: 99%

Cultural adaptations of CBT: a summary and discussion of the Special Issue on Cultural Adaptation of CBT

Naeem

2019

tCBT

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Cognitive behavioural therapy (CBT) in its current form might not be acceptable to service users from a variety of backgrounds. Therefore, it makes sense to adapt CBT when working with diverse populations. Contributors to this special issue of theCognitive Behaviour Therapisthave tackled the issues around the cultural adaptation of CBT from various perspectives, using a variety of methods, and have addressed topics ranging from cultural adaptation to improving access to CBT. Here, I briefly summarize and discuss the papers in this special issue. I start with a systematic review of CBT for social anxiety across cultures. Seven articles cover aspects of adaptation of therapies for people from different backgrounds. Three papers discuss the issues of gender and sexuality when using CBT, while another three papers focus on refugees, asylum seekers and the homeless, and two papers describe the application of CBT with religious populations. Finally, there are seven papers on issues related to service delivery, practice and training and supervision when working with a diverse population. Collectively, papers in this special issue provide us with sufficient evidence that cultural considerations play a vital role when using CBT, offer practical suggestions for improving cultural competence and most importantly, can catalyse future research. However, the full potential of culturally adapted interventions will not be realized until and unless access to CBT is improved. Therefore, there is a need to build robust evidence to convince funders, policy makers and service managers.

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“…Case study examples found the therapists were able to include all these components and successfully engage the African-Caribbean service users in FI (Berry et al, 2018). Furthermore, therapists were able to do this in the absence of biological family members and the FSM were viewed as an effective alternative (Berry et al, 2018).…”

Section: Interventionmentioning

confidence: 99%

“…(1) Engagement and Assessment (focused around building trust with mental health professionals), (2) Shared Learning (addressed illness beliefs and explanatory models), (3) Communication (aided family members and service users in speaking with each other and to health professionals), (4) Problem-Solving and Stress Management (geared at helping families to better manage stressors to reduce tension), and (5) Maintaining Gains and Staying Well (developed a crisis plan to attempt to reduce pathways into care involving police). Case study examples found the therapists were able to include all these components and successfully engage the African-Caribbean service users in FI (Berry et al, 2018). Furthermore, therapists were able to do this in the absence of biological family members and the FSM were viewed as an effective alternative (Berry et al, 2018).…”

Section: Interventionmentioning

confidence: 99%

Exploring service user and family perspectives of a Culturally adapted Family Intervention (CaFI) for African‐Caribbean people with psychosis: A qualitative study

Jensen

Carr

Degnan

et al. 2021

British J Clinic Psychol

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Objectives. In the UK, people of African-Caribbean background have the highest rates of psychosis and greatest inequity in mental health services of all ethnicities. National policies have highlighted the lack of evidence-based psychological interventions for this group. The aim of this study was to examine the acceptability of a novel Culturally adapted Family Intervention (CaFI) for African-Caribbean individuals diagnosed with non-affective psychosis and their relatives. Design. A qualitative design.Methods. Semi-structured interviews conducted with 22 service users and 12 family members following participation in CaFI. The interview topic guide included perceptions of the needs and benefits of CaFI; usefulness, cultural specificity and accessibility of CaFI therapy and supporting materials; content and delivering of CaFI sessions; views and experiences of working with CaFI therapists; and perceived barriers and facilitators to implementation.Results. Deductive framework analysis identified three main themes for service users: perceived benefits, barriers and limitations, and delivery of the therapy. Four themes were identified for family members: perceived benefits, perceptions of therapists, delivery of therapy, and accessibility of therapy content, supporting materials, and cultural appropriateness.Conclusions. CaFI was found to be an acceptable intervention for African-Caribbean service users with psychosis and their relatives. Family interventions considering the needs of ethnic and cultural groups have the potential to improve the mental health care and experiences of service users and their families. Practitioner pointsThe Culturally adapted Family Intervention (CaFI) was viewed as acceptable to African-Caribbean service users with psychosis and their families.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Culturally adapted Family Intervention (CaFI): case examples from therapists’ perspectives

Cited by 5 publications

References 22 publications

Exploring the effectiveness of family-based interventions for psychosis in low- and middle-income countries: a systematic review

Exploring the effectiveness of family-based interventions for psychosis in low- and middle-income countries: a systematic review

Cultural adaptations of CBT: a summary and discussion of the Special Issue on Cultural Adaptation of CBT

Exploring service user and family perspectives of a Culturally adapted Family Intervention (CaFI) for African‐Caribbean people with psychosis: A qualitative study

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