Background
Behavioural Activation (BA) has been found to be as
effective at treating depression as CBT and has been
successfully adapted to be appropriate to the needs of
minority groups (Mir et al, 2015; Kanter et al, 2010).
WHO and NICE guidelines suggest that psychotherapies
should be culturally appropriate to effectively meet the
needs of diverse communities. However, poor uptake of
psychological therapy by religious minority groups in the
UK has been reported (Choudhry and Mir, 2021).
Method :
A randomised controlled trial in a Northern England city,
with a considerable Muslim population. Individuals
accessed either culturally adapted therapy (BA-M) or
usual treatment via NHS primary care (IAPT) or a
voluntary sector service. Participants were randomised to
receive between 6-12 sessions of the culturally adapted
therapy or Treatment as Usual (TAU), which consisted of
either CBT (via IAPT), or a range of social activities
offered by one of three voluntary sector services
participating in the study.
Participants were invited to be interviewed about their
therapy experience, including how acceptable they found
the BA-M approach and how it compared to usual
support.
Results
142 participants were recruited to the study, with 80
allocated to receive BA-M and 62 to receive TAU.
Participants were interviewed about their experiences of
BA-M (N=34), from both the voluntary sector and NHS
services. Participant interviews included service users
(n=18), included some who dropped out of therapy;
therapists (n= 9) and managers/supervisors (n= 7).
Statistical evaluation showed BA-M significantly
reduced depression scores compared to TAU, primarily
through improved engagement with therapy. Both service
users and therapists perceived the adapted approach to be
more meaningful and motivating than TAU. Where
delivery did not follow the protocol, some service users
expressed dissatisfaction, indicating the importance of
values assessment in delivery of BA-M
References
Mir G, Meer S, Cottrell D, McMillan D, House A
&Kanter JW. Adapted behavioural activation for the
treatment of depression in Muslims. Journal of Affective
Disorders. 2015;180: p.190-199.
Kanter JW, Santiago-Rivera AL, Rusch LC, Busch AM
& West P. Initial outcomes of a culturally adapted
behavioral activation for Latinas diagnosed with
depression at a community clinic. Behavior Modification,
2010; 34(2): p.120-144.
Depression in adults: treatment and management
guidelines. National Institute of Clinical Excellence
(UK); 29 June 2022. P113.
www.nice.org.uk/guidance/ng222
Choudhry Z, Mir G. Behavioural Activation for Muslims
(BA-M): a model for faith-based depression therapy in
religious groups. JBIMA. 2021 December; 9(3): 1-6
