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Research led by CAMH with partner organizations nationwide to create tools for an evidence-based and effective psychotherapy for Canadians of South Asian origin
There are 2.6 million Canadians of South Asian origin in Canada, making them the largest racialized group in the country, constituting 7.1% of the total Canadian population. South Asian Canadians are affected by higher rates of anxiety and mood disorders compared to other populations, and are also 85 per cent less likely to seek treatment than other Canadians who experience the same illness. The lower use of mental health services highlights the need for appropriate care for these populations.
Few formal culturally adapted treatments have been implemented or evaluated for mental health services. Still, the few studies that had been conducted indicated that culturally adapted cognitive behavioural therapy (CaCBT) is more effective than standard cognitive behavioural therapy (CBT) and could be a valuable treatment option for people with mental health problems in Canada.
"The goal we worked on was exactly what I was hoping to work on. I love that [my therapist] just got it! She knew the culture and I didn’t have to spend time informing her about my culture."
With funding from Health Canada, CAMH collaborated with the following organizations:
Overall, participants who received CaCBT reported lower levels of mental illness symptoms and higher self-reported overall health than those receiving standard CBT. The number of mental health visits to a psychiatrist, psychologist and other medical doctors was also significantly lower in the CaCBT group, indicating that expanding this therapy more widely in Canada could reduce strain on the healthcare system.
See below for links to the full research report, as well as CaCBT tools developed as part of this study aimed at both mental health professionals and those seeking treatment.
Development and Evaluation of Culturally Adapted CBT to Improve Community Mental Health Services for Canadians of South Asian Origin: Final Report
This report outlines a three-phased mixed-methods study focused on the cultural adaptation of CBT for South Asian populations in Canada experiencing depression and anxiety.
Phase 1: Cultural Adaptation of CBT
Culturally adapting CBT for South Asian populations in Canada through qualitative interviews with stakeholders
Participants were asked about their beliefs about mental health, illness and treatment relevant to the South Asian community.
Phase 2: Pilot Feasibility Testing of culturally adapted CBT (CaCBT)
Testing the newly developed CaCBT for feasibility, acceptability and effectiveness through a randomized controlled trial method.
Participants were enrolled in the study and randomly assigned to receive either CaCBT or standard CBT.
Phase 3: Implementation & Evaluation of CaCBT
Training therapists across Canada in CaCBT.
A random sample of therapists were interviewed. Using the feedback from the interviews from this phase, changes were made to the manual to reflect the diversity of the South Asian population
Project activities were carried out in three geographical locations in Canada: the Greater Toronto Area, Metro Vancouver and Ottawa.
In Phase 1, common themes that arose from interviews with stakeholders included increasing awareness surrounding mental health and illness; need for therapists to have cultural humility and understanding; and importance of modifying CBT techniques to better suit South Asian clients.
In Phase 2, results showed that in all symptom measures, the CaCBT group scored lower than the standard CBT group, and that compared to standard CBT, the CaCBT group had higher levels of engagement and satisfaction, and greater therapeutic relationship between therapist and client.
In Phase 3, therapists from various backgrounds had significantly greater knowledge of multicultural counselling following the training along with a significant increase in cultural adaptation knowledge.
Our findings indicate that mental health services can be developed in a way that is culturally sensitive and culturally appropriate for Canadians of South Asian origin.
Outlining its background, methodology, findings, and recommendations (Available in English and French).
For mental health professionals
Training package
CaCBT Manual: that gives mental health professionals hands-on techniques for implementing the therapy including quick tips, handouts, and easy-to-use summary sheets (available in English and French).
Training Videos: to supplement the manual and enrich trainees’ experience while learning about CaCBT. Videos include role-play scenarios, learning activities, and summary of concepts to help learners enhance their CaCBT training experience.
Information Flyer for Mental Health Professionals
Provides details about CaCBT, along with quotes from service users and mental health professionals about their experience with the intervention (available in English and French).
For general public
Information Flyer for Service Users
Provides CaCBT information on what to expect from the therapy, and quotes from individuals who previously received the intervention (Available in English, Bengali, Gujrati, Hindi, Punjabi Tamil and Urdu).
