Cultural Adaptation of CBT for Serious Mental Illness: A Guide for Training and Practice

353 Pages·2015·1.784 MB·English

by  Shanaya Rathod, David Kingdon, Narsimha Pinninti, Douglas Turkington, Peter Phiri

Cultural Adaptation of CBT
for Serious Mental Illness
This book pulls together all the current data on the effectiveness of culturally sensitive CBT in
this area, as well as providing clinicians with a manual to learn and practice culturally informed
CBT. I can confidently recommend it as helpful for anyone working with severely mentally ill
clients.
Aaron T. Beck, MD, University Professor Emeritus of
Psychiatry, University of Pennsylvania
This volume offers a practical guide to culturally adapting CBT for severe mental health condi-
tions. The authors are gifted clinicians and investigators that present a sophisticated overview of
key conceptual and pragmatic issues in working with diverse communities. The book proposes
novel concepts and applications of a well-established evidenced-based treatment in which lan-
guage, culture, race, and ethnicity are integral to the conceptualization and process of therapy.
This book is a remarkable contribution to the growing literature on cultural adaptations and as
such it represents a major contribution to multicultural psychology and mental health. This is
essential reading for clinicians and scholars interested in working with the diverse majority-
world communities.
Guillermo Bernal, PhD, Director, Institute for Psychological Research,
University of Puerto Rico, Rio Piedras, Puerto Rico
There was a time when psychological therapies were not thought to be appropriate for all
patients, especially those of low socio-economic or poor educational status, and ethnic minori-
ties, refugees, migrants or people from low and middle-income countries. Clinicians did not have
the tools to adapt their skills. No more! Combining psychoanalytic, cognitive behavioural and
general therapeutics theory with evidence on the cultural adaptation of psychological therapies,
this impressive, accessible and timely volume offers hope to patients of diverse cultural heritage,
beliefs, and practices.
Kamaldeep Bhui, Professor of Cultural Psychiatry & Epidemiology,
Queen Mary University of London
In a globalized world we need methods to adapt interventions so they are equally effective for
different groups. One size fits all and culture and color blind approaches hardwire inequity.
Many have undertaken cultural adaptations but to have some of the major voices in CBT
produce guidance on cultural adaptation produces a priceless treasure. Whether you are
developing services in a low income country or for marginalised groups in a high income coun-
try this book will help you produce the most effective CBT for the people you serve.
Kwame McKenzie, MD, FRCPsych (UK), Medical Director CAMH,
Professor of Psychiatry, University of Toronto
With its clear, thoughtful prose and its diverse, vivid case examples, this guide will help CBT
practitioners sensitively handle the challenges of working with individuals and families from a
wide variety of cultural, religious, and spiritual backgrounds. By using these approaches, unique
and thorny challenges to the cross cultural application of CBT can be creatively and collabora-
tively addressed and resolved.
Ron Unger LCSW, CBT for Psychosis Therapist and
Adjunct Professor at Portland State University
Culturally informed mental health care is rapidly moving from an attitudinal orientation to an
evidence-based approach. This textbook makes an important contribution towards understand-
ing the conceptual basis and evidence behind cultural adaptation of cognitive behavioral therapy,
but also provides clinical and contextual guidance in application for diverse populations and
serious psychiatric disorders. A must-read for the clinician who wishes to serve the majority of
patients we will be serving as cultural plurality is achieved in the US and globally.
Andres J Pumariega, MD, Professor and Chair, Department of Psychiatry,
Cooper Medical School of Rowan University and Cooper Health System;
Cochair, Diversity and Culture Committee; and first author of the Practice
Parameter for Cultural Competence, American Academy of
Child and Adolescent Psychiatry
Cultural Adaptation of CBT
for Serious Mental Illness
A Guide for Training and Practice
Shanaya Rathod
David Kingdon
Narsimha Pinninti
Douglas Turkington
Peter Phiri
This edition first published 2015
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The right of Shanaya Rathod, David Kingdon, Narsimha Pinninti, Douglas Turkington and Peter
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Library of Congress Cataloging-in-Publication Data
Rathod, Shanaya, author.
Cultural adaptation of CBT for serious mental illness : a guide for training and practice / Shanaya
Rathod, David Kingdon, Narsimha Pinninti, Douglas Turkington, Peter Phiri.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-118-97620-3 (hardback : alk. paper) – ISBN 978-1-118-97619-7 (paperback : alk. paper)
I. Kingdon, David G., author. II. Pinninti, Narsimha, author. III. Turkington, Douglas, author.
IV. Phiri, Peter, author. V. Title.
[DNLM: 1. Cognitive Therapy–methods. 2. Cultural Diversity. 3. Mental Disorders–therapy.
WM 425.5.C6]
RC489.C63
616.89′1425–dc23
2015000040
A catalogue record for this book is available from the British Library.
Cover image: Illustration © Paul Oakley
Set in 10/12.5pt Sabon by SPi Publisher Services, Pondicherry, India
1 2015
Contents
About the Authors vii
Foreword ix
Preface xi
Acknowledgements xiii
1 Introduction 1
2 Cultural Adaptation of Cognitive Behavioural Therapy:
Principles and Challenges 14
3 Philosophical Orientation and Ethical and Service Considerations 46
4 The Therapeutic Relationship and Technical Adjustments 86
5 General Theoretical Modifications in Orienting Clients to Therapy 121
6 Individualized Case Formulation 135
7 Individualized Treatment Planning 165
8 Psychosis: Cultural Aspects of Presentation and Adaptations
to Treatment 192
9 Depression: Cultural Aspects of Presentation and Adaptations
to Treatment 227
vi Contents
10 Bipolar Affective Disorder: Cultural Aspects of Presentation
and Adaptations to Treatment 248
11 Recovery, Relapse Prevention, and Finishing Therapy 273
12 Policy and Training Implications 293
Appendix
1 Social Factors: My Immigration Journey 306
2 Aida – Longitudinal Formulation 308
3 Setting Goals to Improve Quality of Life 310
4 Voices Diary 312
5 What Do Voices Say? 314
6 Working on Coping Strategies: Pleasant Events Schedule 315
7 Preventing a Relapse or Breakdown 317
8 Circle of Support 320
9 Relapse Prevention Plans 322
Index 326
About the Authors
The authors are recognized authorities in CBT for mental illness and have written
a number of well-received books on these topics. In this new volume, they com-
bine their expertise to produce a compelling learning program for clinicians who
want to gain CBT skills for working with patients from different cultures.
Shanaya Rathod, DM, MRCPsych
Dr Rathod is a Consultant Psychiatrist, Clinical Services Director and Director of
Research at the Southern Health NHS Foundation Trust in the UK. She has been
a Fellow of the National institute for Health and Care Excellence, UK. She has a
particular interest in the cultural and religious aspects of psychopathology of
mental illness and has received grants from the Department of Health Delivering
Race Equality Group (UK) to explore this area further and develop culturally
sensitive cognitive behaviour therapy for psychosis. She has authored a number of
papers in peer reviewed journals, book chapters and books. She has been invited
to present nationally and internationally.
David Kingdon, MD, FRCPsych
Prof Kingdon is Professor of Mental Health Care Delivery at the University of
Southampton, UK and honorary Consultant Psychiatrist at the Southern Health
NHS Foundation Trust. He has chaired the Expert Working Group leading to the
Council of Europe’s Recommendation 2004 (10) on Psychiatry and Human Rights
(1996–2003) and has advised on many national policy initiatives. His research inter-
ests are in cognitive behaviour therapy (CBT) of severe mental illness and mental
health service development on which he has published over 100 papers, chapters and
books. He is visiting Professor at State University of New York and Anding Hospital,
Beijing and has given many invited workshops and lectures internationally.
Narsimha R. Pinninti, MBBS, DPM, MD (Psy)
Dr Pinninti is Professor of Psychiatry at Rowan University school of Osteopathic
Medicine in New Jersey and also Chief Medical Officer, at Twin Oaks Community
viii About the Authors
mental health services Inc in Cherry Hill, NJ. Dr Pinninti is a clinician, adminis-
trator, teacher and researcher who works at the interface of research and clinical
practice. His main interest is in adapting cognitive behaviour therapy and other
psychosocial interventions in real world clinical situations and systems of care.
He is the treating psychiatrist for Camden County Assertive community treatment
team, oversees psychiatric services for Twin Oaks Community health services, and
course director for CBT training for psychiatric residents at Rowan School of
Osteopathic Medicine. He has been invited to present in a number of national
workshops and published over 40 articles in peer reviewed journals.
Douglas Turkington, DM, MRCPsych
Prof Turkington is Professor of Psychosocial Psychiatry, Newcastle University,
UK. He has project managed a number of high impact randomized controlled
trials in CBT of schizophrenia in the UK and done research on this topic in Texas,
Beijing, Valencia and Illinois. His work has strongly influenced the NICE guidelines
in the UK. He has lectured widely throughout China, Europe and North America,
including Rome, Turkey, Spain, Ontario, Ohio, Sacramento and York. He is founding
fellow of the Faculty of Cognitive Therapy in Philadelphia and has written more
than 100 articles on the subject of CBT in schizophrenia. He has also with
Professor David Kingdon co-authored or edited eight highly influential books on
CBT for schizophrenia.
Peter Phiri, RMN, DipCBT, BSc, PhD
Dr Phiri is a Senior Researcher and a Cognitive Behaviour Therapy Specialist
( accredited with the British Association of Behavioural and Cognitive
Psychotherapies: BABCP) at Southern Health NHS Foundation Trust in the UK. His
interest is in cultural adaptations of CBT with diverse groups. He is also an Honorary
Lecturer and Academic Supervisor in CBT Diploma and IAPT programmes at the
University of Southampton and a Visiting Lecturer at Bath University. He has pub-
lished a number of papers in this field and has presented in workshops and confer-
ences both nationally and internationally.