Cultural Adaptation of Group CBT Psychosis Manual and Establishing Its Efficacy in Pakistan

A clinical trial was conducted aiming to culturally adapt and pilot test a group Cognitive Behavioral Therapy for psychosis (CBTp) protocol for Pakistani patients diagnosed with schizophrenia spectrum disorder. This research was particularly significant given the prevalence of psychosis in Pakistan and the scarcity of trained therapists, especially in government hospitals.

Methodology:

Participant Selection: Purposive sampling was utilized to select participants from the Psychiatric Institute of Mental Health (PIMH) who were diagnosed with schizophrenia spectrum disorder and were inpatients receiving medication.

Sample Size: A total sample of N=50 was obtained, with participants randomly assigned to either the experimental (N=25) or control group (N=25).

Assessment Measures: Various assessment measures were employed to evaluate the efficacy of the intervention, including the Positive and Negative Syndrome Scale of Schizophrenia (PANSS), Rosenberg's Self Esteem Scale, Insight Scale, Brief COPE, Perceived Stress Scale, and The Psychotic Symptom Rating Scales (PSYRATS).

Intervention: The experimental group received manualized group CBT intervention consisting of 24 sessions over a duration of 3 months. The intervention was culturally adapted to suit the needs and context of Pakistani patients. Importantly, there were no dropouts from either group during the intervention period.

Statistical Analysis: An analysis of covariance (ANCOVA) was conducted to compare pre- and post-intervention ratings between the experimental and control groups.

Inclusion criteria

A clinical diagnosis of schizophrenia or psychotic disorder for at least 5 years.

Aged between 18 and 65.

The exclusion criteria :

A severe learning disability, an organic brain disorder , a high level of disturbed behavior, or a significant risk of suicide or homicide.