Psychologists experience of cognitive behaviour therapy in a developing country: a qualitative study from Pakistan

In depth semi structured interviews were conducted with 5 psychologists working in psychiatry departments in Lahore, Pakistan.All the psychologists reported that psychotherapies, including CBT, need adjustments for use in Pakistan, although they were not able to elicit on these in details. Four major themes were discovered, hurdles in therapy, therapy related issues, involvement of the family and modification in therapy. The biggest hurdles in therapy were described to be service and resource issues.For CBT to be acceptable, accessible and effective in Non Western cultures numerous adjustments need to be made, taking into consideration; factors related to service structure and delivery, patient's knowledge and beliefs about health and the therapy itself. Interviews with the psychologists in these countries can give us insights which can guide development of therapy and manuals to support its delivery.Cognitive behaviour therapy has become established as the most researched and effective psychological intervention for a wide range of mental disorders including depression, anxiety, Obsessive Compulsive Disorder, Bulimia, Personality Disorders and Schizophrenia within the developed countries [1-5]. Although, there have been limitations on availability, National Clinical Guidelines are leading to therapy being made available across the developed world (for example clinical guidelines for the treatment of depression, by the National Institute of Clinical Excellence (NICE), UK http://www.nice.org.uk webcite.Currently, CBT is only rarely available in the Non Western, developing countries. There is some evidence to suggest that CBT might be effective in treating mental health problems in developing countries [6-8]. The cost of medicines in the developing world might inhibit effective treatment availability [9]. Due to the low cost of available human resources, psychological help may be less costly to provide with additional therapeutic benefits and as an alternative to medi