Skip to main content

Archived Comments for: Identification, modification, and implementation of an evidence-based psychotherapy for children in a low-income country: the use of TF-CBT in Zambia

Back to article

  1. Participatory reserch to select, adapt, test and refine Evidence Based Interventions on Low resource countries 

    farooq naeem, Department of Psychiatry, Queens University, Kingston, ON, Canada & Pakistan Association of Cognitive Therapists

    20 November 2014

    We read Murray et al’s paper with interest. We have adapted Cognitive Behaviour Therapy (CBT) for local use in Pakistan. This work consisted of mixed methods and was underpinned by an ethnographic approach. We conducted a series of qualitative studies in Pakistan, including interviews with mental health professionals, students and patients to adapt CBT for depression (Naeem et al, 2010, 2012, 2009).  Information gathered from these preparatory qualitative studies, as well as our field observations, experience of therapy and clinical practice were collated to develop an adaptation framework that guided the CBT adaptation process (Naeem et al, 2009). We further refined the adaptation techniques to adapt CBT for psychosis (Naeem et al, 2014).  Randomized Controlled Trials to test this culturally adapted CBT found it to be effective for depression, when delivered by psychology graduates (Naeem et al, 2011), in a self help format (Naeem et al, 2014), and for psychosis (Habib et al, 2014).

    Our work highlighted the importance of involving different stake holders in adapting therapy through qualitative work. Therapy and the process of adaptation was further refined during the past few years. we therefore believe that the selection, adaptation and application of adapted therapy is an ongoing process that should involve stake holders at all stage.


    Naeem, F., Ayub, M., Gobbi, M., & Kingdon, D. (2009, December 1). Development of Southampton Adaptation Framework for CBT (SAF-CBT) : a framework for adaptation of CBT in non-western culture. Retrieved June 10, 2012, from

    Naeem, F., Ayub, M., Kingdon, D., & Gobbi, M. (2012). Views of Depressed Patients in Pakistan Concerning Their Illness, Its Causes, and Treatments. Qualitative Health Research

    Naeem, F., Gobbi, M., Ayub, M., & Kingdon, D. (2009). University students’ views about compatibility of cognitive behaviour therapy (CBT) with their personal, social and religious values (a study from Pakistan). Mental Health, Religion & Culture, 12(8), 847–855

    Naeem, F., Gobbi, M., Ayub, M., Kingdon, D., & others. (2010). Psychologists experience of cognitive behaviour therapy in a developing country: a qualitative study from Pakistan. International Journal of Mental Health Systems

    Naeem, F., Sarhandi, I., Gul, M., Khalid, M., Aslam, M., Anbrin, A., … Ayub, M. (2014). A multicentre randomised controlled trial of a carer supervised culturally adapted CBT (CaCBT) based self-help for depression in Pakistan. Journal of Affective Disorders, 156, 224–226

    Naeem, F., Waheed, W., Gobbi, M., Ayub, M., & Kingdon, D. (2011). Preliminary Evaluation of Culturally Sensitive CBT for Depression in Pakistan: Findings from Developing Culturally-Sensitive CBT Project (DCCP). Behavioural and Cognitive Psychotherapy, 39(02), 165–173

    Naeem F, Habib N, Gul M, Khalid M, Saeed S, Farooq S, Munshi T, Gobbi M, Husain N, Ayub M, Kingdon D.A Qualitative Study to Explore Patients', Carers' and Health Professionals' Views to Culturally Adapt CBT for Psychosis (CBTp) in Pakistan. Behav Cogn Psychother. 2014 Sep 2:1-13

    Habib N, Dawood S, Kingdon D, Naeem F.Preliminary Evaluation of Culturally Adapted CBT for Psychosis (CA-CBTp): Findings from Developing Culturally-Sensitive CBT Project (DCCP). Behav Cogn Psychother. 2014 Jan 2:1-9.     


    Competing interests