Cognitive behavioural therapy training in Tanzania: a qualitative study of clinicians’ experiences

Abstract

Cognitive behaviour therapy (CBT) in an effective technique used widely in Western countries. However, there is limited evidence as to the utility, perception and understanding of CBT in developing countries. This study describes and investigates the experience of CBT training and practice in a group of practitioners in Tanzania. A qualitative approach to the investigation was used, and seven participants from Tanzania’s only psychiatric hospital who had completed CBT training were interviewed. The resulting verbatim transcripts were analysed via interpretative phenomenological analysis. Five superordinate themes emerged from the analysis: ‘the medical model’, ‘novelty’, ‘practicalities’, ‘process’ and ‘therapist effects’. The two themes ‘therapist effects’ and ‘process’ are discussed in detail as these may be particularly relevant to the clinical application of the therapy in a new culture and context. The implications for future development of CBT in Tanzania are considered. In developing CBT for dissemination in Tanzania, specific cultural and clinical issues highlighted by indigenous clinicians need consideration.Key learning aims(1)To identify what range of factors may influence clinicians’ perception of and learning about CBT when CBT training is delivered in a mental health setting in Tanzania, or to those with East African origins.(2)To consider the use of qualitative research approaches to inform the early stages of adapting CBT for use in new settings and applications.(3)To be able to apply knowledge about cultural differences to standard CBT in order to promote culturally sensitive practice.

Cultural adaptations of CBT: a summary and discussion of the Special Issue on Cultural Adaptation of CBT

“…Cognitive behavioural therapy training in Tanzania: a qualitative study of clinicians' experiences (Stone and Arroll, 2019) Stone and Arroll report a qualitative study to explore the experiences of therapists trained in CBT in Tanzania. Seven participants from Tanzania's only psychiatric hospital who had completed CBT training were interviewed.…”

Tanzanian rural psychological services: Opportunities and challenges.

“…Furthermore, we must strive to be aware of the culturally encapsulated approaches that we are most familiar with in the Western world, and not automatically assume that these approaches are best for those in the countries we are striving to support. Rather, Western psychologists are encouraged to support and incorporate local wisdom and expertise while providing a Western treatment such as cognitive–behavioral therapy (CBT), given the potential benefit evidence-based practices may have for patient groups that exist across cultures (Stone & Arroll, 2019). Incorporation of cultural context and characteristics (e.g., local metaphor, social dynamics, and unwritten rules) should be carefully woven into any possible adaptation of Western treatments to non-Western geographies and communities.…”