Preliminary adaptation of cognitive behavioral therapy for major depression in the Bangladeshi context: a pilot study.

Abstract

Cultural values and standard social rules of communities strongly influence any psychological therapy. Being developed and modified in the Western world, cognitive behavior therapy (CBT) is not anyway different from such influences. In this study, CBT was adapted in Bengali to determine the functional feasibility of the psychological intervention for people with depression in Bangladesh. This is the first pilot study of an adapted CBT manual for psychological intervention for working with depressive clients in Bangladesh. There were three phases of the study. In the first two phases, the standard protocols of CBT were adapted for the Bangladeshi community, as practiced by mainstream practitioners and mental health professionals around the world. The information gathered during the first phase of the standard protocols of CBT was written in Bengali as the first draft. In the second phase, the CBT manual was judged by seven senior clinical psychologists in Bangladesh who were trained in CBT by British clinical psychologists and later provided training to fellow mental health professionals. After the judges' evaluation, their comments and suggestions were synthesized and the first draft of the adapted intervention was finalized. In the third phase, to evaluate the functional feasibility of the Bengali CBT-based manual, five patients diagnosed with major depression by psychiatrists were tested. Four valid and reliable psychometric measurements were used to measure symptoms of depression and comorbid symptoms of anxiety, psychological distress, and suicidal risk. Assessments were completed at 2 time points (pretest and posttest) via scales. The intervention was delivered within 6 to 10 sessions, and improvements were monitored over the scores of all the questionnaires. The possibilities of Bengali CBTs to reduce depression and appear to be promising treatment options for depression are discussed in this paper.