Facilitators and barriers in the implementation of a culturally adapted Arabic version of Illness Management and Recovery (IMR) among Palestinian Arabs in Israel.

Abstract

The Illness Management and Recovery (IMR) program has been implemented in several countries including Israel. This study examines, from the perspective of Arab practitioners, facilitators and barriers in the implementation of a culturally-adapted version of the IMR intervention among Arabs with serious mental illness in Israel. Fourteen Arab practitioners who had delivered the culturally adapted IMR were interviewed. The analysis of the interviews identified facilitators and barriers, divided into universal factors found when implementing the intervention elsewhere in the world, and culture-specific ones. Facilitators included the manual on which the intervention was based, bypassing verbal communication, ongoing supervision during implementation, the group process, co-facilitation and the cultural adaptations. The barriers included three universal ones: Meeting needs beyond IMR due to service shortage, Reputation is everything: Self- and social stigma and Pulling the others back: Difficulties in reading and writing-and one that was culture-specific: family over-involvement. Identifying facilitators and barriers in the implementation of the adapted IMR can contribute to the implementation of evidence-based practices (EBPs) in the mental health area. Notably, multiple culture-specific facilitators have been identified, as opposed to only one culture-specific barrier, suggesting that cultural differences may be overcome in implementing EBPs developed in the West.