Abstract
Over the last 15 years, Islamic Counselling (the Dharamsi Maynard Model) has developed an evidence base
regarding work with Muslims experiencing common mental health problems. This includes qualitative research,
and quantitative evaluations of both long-term impact and immediate outcomes. Following the BIMA 2025
abstract competition, this paper presents an overview of the evidence base.
Introduction
Islamic Counselling (The Dharamsi Maynard Model)
was first developed in 1996, with the first professional
counsellors entering training with the turn of the century.
Since then, Islamic counsellors and Islamic
psychotherapists have been working with Muslims and
other clients, addressing common mental health problems
and working in conjunction with secondary mental health
teams to support people living with serious mental health
problems.
For 15 years, Islamic counsellors have worked providing
these services through The Lateef Project, a voluntary
sector primary mental health care provider which aims to
address clients’ common mental health problems through
this model. In addition, it addresses the systemic mental
health inequalities of Muslims through influencing or
enabling better therapeutic practice for Muslims. During
this time, The Lateef Project has commissioned
independent qualitative analysis of Islamic Counselling,
long-term quantitative analysis of the impact of Islamic
Counselling, and an evaluation of the immediate
therapeutic outcomes of Islamic Counselling. Though
most of this evidence is presented in other peer-reviewed
publications, it has not been brought together cohesively.
The objective of this paper is to set out the evidence to
date supporting this model of Islamic Counselling,
enabling this Islamic psychological therapeutic approach
to be considered in relation to Occidental therapeutic
practice, (generally understood as Western therapeutic
practice, this change of terminology is employed to
decentre current normative thinking). This is specifically
concerning the outcomes experienced by Muslims living
with common mental health problems.
Understanding that Islamic Counselling is ontologically
and epistemologically more aligned with the faith-based
understandings of self and reality of the global majority
than many secular therapeutic approaches, it is hoped that
future research will present the benefits of Islamic
Counselling not only to Muslims, but to clients in
general, and to mental health practice.
Qualitative evidence of Islamic Counselling client experience
In 2021, Agata Podstepska, an MSc Psychology student
from the University of Westminster, carried out a
qualitative study of the experience of 9 Muslim clients (7
female, 2 male) concerning Islamic Counselling. The
following are some of the key findings.
Clients considered the centrality of their faith as a
definitional core to their sense of self and well
so central to the therapeutic process.
“…for most Muslims, their faith is a huge part of who
they are, a huge part of their identity and how they frame
everything that they do in this life. – Participant 4
“that’s my identity, like that is who I am, you know,
Islam is part of me.” – Participant 7
“But at least I knew that she would know where I’m
coming from. And she would know that my beliefs are
important to me, and that she wouldn’t question my
beliefs… so I wouldn’t feel attacked.” – Participant 4
In this context, clients also reported their experi
engaging with generic CBT, for example:
“… a lot of the issues that I have in my life are very
much related to Islamic, you know, concepts of Islamic
way of life…that one time that I did do counselling with
a non-Muslim, for CBT, I actually stoppe
finding that was benefiting me… I found that I was
having to explain more when I was talking about Islamic
things. So like, for example, my prayers I would have to
explain it to her even before we get to it…. And I just felt
that she just, she just didn’t understand it.”
Participant 3
Podstepska noted that:
“Not only do clients work to resolve their mental health
difficulties, but they also benefit from the spiritual aspect
of the process, which in turn, can help them improve
their faith and relationship with God… Islamic
counselling can also allow clients to discover “answers”
by providing the space to explore issues from both
psychological and spiritual perspectives without
judgement or directly providing Islamic advice.”
As indicated here:
“… questioning it, saying okay, so which part of that is
from the culture and which part of that is from this
Islamic culture…And then which part of it is the truest
form of Islam that the prophet (saw) actually taught…
Islam promotes freedom for women and so for you to
actually ask questions and explore that is what Islam
actually promotes.” – Participant 1
“… there’s things… your core level, which you want to
get Islamic counselling for, and then there’s other things ike, insecurities, for example, which you could possibly,
you know, have normal counselling for.”
With this, clients found the process of Islamic
Counselling valuable:
“I’m not going to say this lightly, but honestly, it’s
changed my life for me, it’s completely,
how I see stuff, how I look at everything and it’s just, it
was just a nice environment to be in”
“I’m definitely feeling a lot more positive, yeah, a lot
happier and feel like I’ve kind of accepted things more
and I feel like I’m in a much better position in my
relationships”- Participant 8
Long term quantitative outcomes-based research on Islamic Counselling
In 2011, The Lateef Project conducted an independent
long-term evaluation of the impact of Islamic
Counselling on Muslim NHS patients’ use of secondary
care. This was one year before and one year post first
Islamic Counselling intervention. The focus of this study
was a significant number of Muslim NHS patients who
were presenting at primary care with long
conditions or medically unexplained symptoms (MUS),
and common mental health problems. They were
frequent returners to primary care. As these patients also
often attended secondary care, the question was whether
Islamic Counselling impacted patient use
secondary care. There were 2 hypotheses:
WORKING HYPOTHESIS 1
The consultation rate within primary care would
increase or be contained.
WORKING HYPOTHESIS 2
The attendance rate within secondary care would
significantly reduce.
The results of this study concerning hypothesis 1.
Analysis through tracking of patient EMIS numbers by
quarter showed that, regarding primary care consultation
rates for the patients in the 2011 cohort, though a small
number of patients showed a dramatic reduction in
use of primary care, there was an overall increase.
Concerning hypothesis 2, tracking appointment/
attendance/admission rates for the cohort of patients by
quarter (3 months) in 2011 before the Islamic
Counselling intervention in comparison with quarterly
intervals in 2013 (one year before and one year post)
provided the following outcomes. Using
value of 0.05), the results presented in the following
tables are all significant (S Maynard, 2023a).
Within this cohort, a second cohort of patients who
received Islamic Counselling was identified. These were
patients who had attended secondary care five or more
times in the year before the Islamic Counselling
intervention. These figures further demonstrated
reduction in secondary care use.
Further analysis was carried out by NHS CENTRAL
MIDLANDS in 2014 of NHS patients who had
experienced Islamic Counselling; this time, the
parameters were three years before and three years post
intervention. Again, this analysis looked at patient use of
secondary care; however, in addition, it also assessed the
relative costs involved. The results of this work are
presented in the following tables (S Maynard, 2023b).
Tracking patient activity and related cost, over the period
post intervention the evaluation found secondary care
activity was reduced by 441 events, this was accompanied by a reduction in related secondary care
spending of £173,257.
Immediate outcomes: a quantitative evaluation of Islamic Counselling
In March 2025, Abdul Rauf, Noor and Maynard
published further evidence of the efficacy of Islamic
Counselling when used with Muslims experiencing
common mental health presentations of an
depression (Abdul Rauf, Noor, Maynard 2025). This was
an evaluation of immediate outcomes identified by pre
and post-intervention client assessment scores regarding
anxiety and depression. In 2022/23, 76 Muslims were
engaged in a limited programme of Islamic Counselling
across Hackney, Newham, and Tower Hamlets. 66
completed a course of up to 8 sessions of Islamic
Counselling (a dropout rate of 10%).
All participants completed GAD7 and PHQ9 assessments
at the beginning and end of the interventi
participants completed their final assessments within the
funding time frame. Of this group of 52, 51 participants
exhibited caseness regarding anxiety, and 51 participants
exhibited caseness regarding depression (hence 50, 96%
presented with both conditions). 50 of the participants
presented in one of the 2 upper thresholds in at least one
condition.
A comparison of GAD7 and PHQ9 assessment scores
before and after intervention was completed, and the
difference when t-tested, was found to be signif
Islamic Counselling was provided by bilingual
counsellors in English, Sylheti, Turkish and Urdu. A
maximum of 6 sessions in English, Sylheti and Turkish
were given. Due to the limited fluency of the Islamic
Counsellor who spoke Urdu, 2 additional
available to Urdu-speaking clients.
The control group for this study was the post
outcomes for the CCG, which includes these three
boroughs, noting that across the CCG, most NHS patients
receiving treatment would not be Muslim and so wo
not experience the mental health inequalities Muslims
experience.
The following tables present some of the outcomes of
this evaluation.
The study shows that within the sample of clients who
received Islamic Counselling, within 8 sessions, the
symptomatology of 82% of clients with anxiety was
reduced by a threshold or more. The study further shows
that for clients experiencing depression upon completion
of the Islamic Counselling intervention 67% of clients
experienced a reduction in their symptomatology of at
least one threshold as evidenced b
assessments.
Following the intervention, 3 clients who previously
presented with anxiety were below the threshold for
caseness, 8 clients who previously presented with
depression were below the threshold for caseness, and 2
clients were below the threshold for caseness concerning
both conditions.
By comparison, the data from the control group for that
period showed that for the people who demonstrated
caseness and completed a course of CBT for anxiety,
60% showed improvement, while for tho
condition was identified as depression, 61% showed
improvement.
Comparison of the immediate outcomes for Muslim
clients experiencing Islamic Counselling as opposed to
CBT with presentations of anxiety and depression shows
that Islamic Counselling outperforms CBT.
Considering the significance of the evidence supporting Islamic Counselling
Since records have been kept regarding faith and mental
health in the UK, there has been evidence of Muslim
mental health inequalities (Health and Social Care
Information Centre, 2016, and Moller, NP, Ryans, G.,
Rollings, J, 2018).In addressing these inequalities,
qualitative and long-term quantitativedata
presentedabove show positive outputs and outcomes
concerning Muslim mental health. The 2025 Shafan
Azhar et al large cohort study of over 70,000 NHS
Talking Therapies for anxiety and depression patients
across faiths, with 10350 participating Muslims, found:
1. Muslims were most likely to live in deprived
neighbourhoods and be unemployed; 3895 Muslim
patients (37.6%) were living in the most deprived
quintile of areas in England.
2. Muslim patients also had the highest average
depression (PHQ-9), anxiety (GAD
impairments in social functioning (WSAS) scores
before treatment.
3. Muslim patients were least likely t
the lowest likelihood of reliable recovery regardless
of adjustment for potential confounders, although
adjustment reduced inequalities in
also showed the second lowest likelihood of reliable
improvement as demonstrated by a
reduction of 4 or more points or 6 or more points in
the GAD7 or PHQ9 assessments respectively.
Set against the above, in the Abdul Rauf, Noor and
Maynard evaluation:
1. Islamic Counselling has been successfully employed
in boroughs with some of the highest levels of
deprivation in London. Prevalence
mental health conditions is greater in areas of
poverty,TTad intervention outcomes
to be reduced relative to poverty (Delgardiloet al
2018).
2. The Muslims given Islamic Counselling first
presented with higher-than-average anxiety scores
and an elevated level of comorbidity for anxiety and
depression.
3. In these contexts, Muslims who received Islamic
Counselling demonstrated reliable improvement
significantly above improvement or reliable
improvement rates in TTad patients across the CCG
following CBT,Muslim or otherwise.
Discussion
This paper presents the clinical evidence supporting
Islamic Counselling to date; an
therapeutic intervention based on an Islamic ontology
and epistemology. Within contemporary Occidental
mental health theories and practice, mental illness is the
primary focus, defined and diagnosed across a variety of
presentations seen to be either common or severe. These
presentations are generally understood in terms of the
impact they have on the functionality of the individual
and, by implication, are framed individually. Seen in an
individual context, mental heal
considered regarding the biology of the person, or the
immediate socialising, (their development in terms of
family relationships, their adult interpersonal
relationships, their interactions with peers or their
immediate social interactions in other contexts such as
work). These are not seen, in a systemic
otherwise (e.g. as a response to increasing and pervasive
Islamophobia or other forms of systemic oppression,
sociopolitical or geopolitical stressors).
With the movement of significant populations of people
from the African, Asian and South American contexts
into the frame of reference of Occidental mental health
for almost a century it has become necessary in mental
health to consider that 84% of the global po
follow a faith, as in live by a cognitive schema that
contextualises their experiential reality including sense of
self. Both Cushman’s Constructing the Self Constructing
America 1995 and Beshara’s Decolonial Psychoanalysis
2019 present the limitations of current Occidental
framing of mental health and well
them in American and European narratives, which are
specific to the cultural context of the people they reflect.
With this, most Occidental psychotherapeutic theory,
including CBT, is secular, conforming with ‘modern’
perceptions of the postmodern European/ American self.
Recent UK, research has often addressed the difference
of Muslims to explain why secular practice is less
effective or explored adaptations of Occidental
interventions to address differences regarding Muslim
engagement with mental health provision and outcomes.
Though some of the adaptations of contemporary
Occidental therapeutic interventions or even the adoption
of spiritual practices into the canon of
practice (such as mindfulness) have improved practice,
these developments omit an axiomatic question:
For people of faith, are therapeutic interventions that are
based in and reflective of their ontology and
epistemology, more effective than secular, or secular
adapted interventions?
Islam developed Maristans, hospitals addressing mental
health in the 8th century. There is a thousand
Islamic knowledge of psychospiritual and psychological
well-being ignored or overlooked in current Occidental
mental health practice.
Islamic Counselling is neither based on the Skinner
therapeutic model (Skinner Kaplick 2017), nor a
derivative of person-centred counselling (Skinner 2021).
Islamic Counselling, the Dharamsi Maynard model is
based on the teachings of the Shadhili tradition of
Tasawwuf.
It is relational and a contemporary Islamic Psychological
therapeutic approach. The development of Islam
Counsellors emphasises the state of being of the Islamic
Counsellor, being both in submission in the therapeutic
process, and in service of the client (service to Allah
through service to the highest of his creation). It is based
on the Quran, Hadith, and Sunna, as well as the teachings
of classical scholars including Al-Ghazali, Ibn Sina and
Al-Miskawayh. Islamic Counselling’s theoretical basis
and related practice are integral to the above evidence.
The evidence of Islamic Counselling demonstrates its
effectiveness in addressing complex common mental
health presentations, discussed further in the original
publications (Maynard 2023a, Maynard 2023b, Abdul
Rauf Noor & Maynard 2025).
The Muslim community in the UK continues to grow,
and simultaneously, so do psychological stressors
experienced by UK Muslims. In this context, Islamic
Counselling presents a way of addressing perhaps not
only Muslim mental health, but mental health, and the
provision of related services in a way that addresses the
lived psychospiritual, socioeconomic, and sociopolitical
realities of marginalised communities here, which maybe
reflective of global majority clients.
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