The Effectiveness of Cognitive-Behavioral Therapy for Treating Anxiety Disorders in Low-Resource Settings in South Africa
DOI:
https://doi.org/10.47604/ijp.2361Keywords:
Cognitive-Behavioral Therapy, Anxiety Disorders, Low-Resource SettingsAbstract
Purpose: The aim of the study was to investigate the effectiveness of cognitive-behavioral therapy for treating anxiety disorders in low-resource settings.
Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries.
Findings: Research suggests that cognitive-behavioral therapy (CBT) is effective for treating anxiety disorders in low-resource settings, demonstrating comparable outcomes to those in high-resource settings. CBT interventions, adapted to the cultural context and delivered by trained non-specialists or through guided self-help formats, have shown promise in improving anxiety symptoms and functional outcomes. These findings highlight the feasibility and potential scalability of CBT for addressing anxiety disorders in resource-constrained environments.
Unique Contribution to Theory, Practice and Policy: Social learning theory, cultural adaptation theory & resource mobilization theory of creativity may be used to anchor future studies on the effectiveness of cognitive-behavioral therapy for treating anxiety disorders in low-resource settings. Interventions should be designed to be flexible and scalable, allowing for adaptation to diverse cultural contexts and resource constraints. policymakers should prioritize the development and implementation of policies that support culturally sensitive and contextually relevant mental health interventions.
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References
Abdulmalik (2018). A cluster randomized controlled trial to evaluate the effectiveness of a group cognitive behavioral therapy for people with mild to moderate anxiety in primary care in Nigeria. BMC Psychiatry, 18(1), 201. DOI: 10.1186/s12888-018-1771-6
Aguilar-Ortiz (2018). Effectiveness of a culturally adapted cognitive-behavioral intervention for anxiety among rural indigenous Guatemalan women. Journal of Clinical Psychology, 74(11), 1972-1985. DOI: 10.1002/jclp.22682
Aguilar-Ortiz (2020). Adapting cognitive-behavioral therapy to cultural variables in low-resource settings: An example from rural Guatemala. Cognitive and Behavioral Practice, 27(4), 458-470. DOI: 10.1016/j.cbpra.2019.05.005
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). DOI: 10.1176/appi.books.9780890425596
Andersson, G., & Cuijpers, P. (2009). Internet-based and other computerized psychological treatments for adult depression: A meta-analysis. Cognitive Behaviour Therapy, 38(4), 196-205. DOI: 10.1080/16506070903318960
Bandura, A. (1977). Social learning theory. Prentice-Hall.
Beck, J. S. (2011). Cognitive behavior therapy: Basics and beyond (2nd ed.). Guilford Press.
Campbell-Hall, V., et al. (2019). Prevalence and correlates of anxiety disorders among adults in South Africa: Results from the South African Stress and Health Study. South African Medical Journal, 109(11), 870-876. DOI: 10.7196/SAMJ.2019.v109i11.13454
Chibanda D, Weiss HA, Verhey R, et al. Effect of a primary care-based psychological intervention on symptoms of common mental disorders in Zimbabwe: A randomized clinical trial. JAMA. 2016;316(24):2618–2626. https://doi.org/10.1001/jama.2016.19102
Esliker R, Kakuma R, Minas H, et al. The effect of a school-based intervention on the mental health and well-being of war-affected children in Liberia: A quasi-experimental study using the Youth Empowerment Program (YEP). Int J Ment Health Syst. 2019;13:66. https://doi.org/10.1186/s13033-019-0324-x
Furukawa TA, Horikoshi M, Fujita H, et al. Cognitive and behavioral therapies versus pharmacotherapy for social anxiety disorder among adults: A systematic review and meta-analysis of randomized controlled trials with 12-month follow-up. J Clin Psychiatry. 2016;77(10):e1317–e1325. https://doi.org/10.4088/JCP.15r10119
Gallo, K. P (2018). Low-intensity cognitive-behavioral interventions for obsessive-compulsive disorder and panic disorder in low- and middle-income countries: A systematic review and meta-analysis. Journal of Anxiety Disorders, 54, 11-19. DOI: 10.1016/j.janxdis.2018.01.001
Garcìa, J. G., & Resendez, M. G. (2002). Culturally adapted cognitive-behavioral therapy: Integrating sexual, spiritual, and family identities. Cognitive and Behavioral Practice, 9(3), 232-242. DOI: 10.1016/s1077-7229(02)80057-5
Gureje, O., et al. (2023). Trends in anxiety symptoms among adults in Nigeria: Evidence from the Nigerian Survey of Mental Health and Wellbeing. Journal of Public Health in Africa, 14(1), 820-827. DOI: 10.4081/jphia.2023.1876
Ho, F. K., et al. (2016). Effectiveness of cognitive-behavioral therapy for anxiety disorders in low-income and middle-income countries: A systematic review and meta-analysis. Bulletin of the World Health Organization, 94(8), 611-621. DOI: 10.2471/BLT.15.164954
Ho, F. K., et al. (2018). Cognitive-behavioral therapy for anxiety disorders in low- and middle-income countries: A systematic review. Asian Journal of Psychiatry, 38, 1-11. DOI: 10.1016/j.ajp.2018.09.014
Iemmi, V., et al. (2016). Treatment for anxiety and depression in Sub-Saharan Africa: A systematic review. PLOS ONE, 11(8), e0159388. DOI: 10.1371/journal.pone.0159388
Jörns-Presentati A, Napp A-K, Dessauvagie AS, et al. The prevalence of mental health problems in sub-Saharan adolescents: A systematic review. PLoS ONE. 2021;16(5):e0251689. https://doi.org/10.1371/journal.pone.0251689
Naeem, F., et al. (2019). A culturally adapted CBT intervention for anxiety disorders in a low-resource setting: A pilot randomized controlled trial. Cognitive and Behavioral Practice, 26(1), 45-59. DOI: 10.1016/j.cbpra.2018.06.001
Ndetei, D. M., et al. (2021). Trends in anxiety symptoms among adults in Kenya: Evidence from the Kenya Mental Health Survey. International Journal of Mental Health Systems, 15(1), 56. DOI: 10.1186/s13033-021-00511-4
Norton, P. J., & Price, E. C. (2007). A meta-analytic review of adult cognitive-behavioral treatment outcome across the anxiety disorders. Journal of Nervous and Mental Disease, 195(6), 521-531. DOI: 10.1097/NMD.0b013e3180302dd8
Ofori-Atta, A., et al. (2020). Prevalence and correlates of anxiety disorders among adults in Ghana: Results from the Ghana Mental Health Survey. Ghana Medical Journal, 54(3), 209-216. DOI: 10.4314/gmj.v54i3.8
Ogawa, S., et al. (2018). Prevalence and correlates of anxiety disorders among adults in the community: Results from the Japan Collaborative Cohort Study. Journal of Affective Disorders, 234, 25-32. DOI: 10.1016/j.jad.2018.02.001
Olayinka OO, Ola BA, Oluwole LO, et al. Cognitive-behavioural therapy for adolescents with emotional and behavioural difficulties in Nigeria: A randomised controlled trial protocol (CABIN study). BMJ Open. 2018;8(11):e023055. https://doi.org/10.1136/bmjopen-2018-023055
Patel, V., et al. (2017). Long-term outcomes of a randomized controlled trial of a manual-based coping strategy intervention in low-resource settings. British Journal of Psychiatry, 211(2), 113-119. DOI: 10.1192/bjp.bp.116.196113
Patel, V., et al. (2018). Culture and the common mental disorders in sub-Saharan Africa. Harvard Review of Psychiatry, 26(6), 334-341. DOI: 10.1097/HRP.0000000000000190
Rahman A, Hamdani SU, Awan NR, et al. Effect of a multicomponent behavioral intervention in adults impaired by psychological distress in a conflict-affected area of Pakistan: A randomized clinical trial. JAMA. 2016;316(24):2609–2617. https://doi.org/10.1001/jama.2016.17165
Roy-Byrne, P. P., et al. (2010). Brief intervention for anxiety in primary care patients. Journal of the American Board of Family Medicine, 23(4), 471-482. DOI: 10.3122/jabfm.2010.04.090216
Smith, K. J., et al. (2019). Trends in anxiety and depression symptom scores in a primary care population over a 10-year period. Journal of Psychiatric Research, 110, 34-37. DOI: 10.1016/j.jpsychires.2018.12.011
Stein MB, Sareen J, Craske MG, et al. Effect of cognitive behavioral therapy vs usual care on fear of cancer recurrence in patients with high-risk cancer: A randomized clinical trial. JAMA Oncol. 2019;5(12):1734–1742. https://doi.org/10.1001/jamaoncol.2019.3323
Terlizzi EP, Villarroel MA. Symptoms of generalized anxiety disorder among adults: United States, 2019. NCHS Data Brief, no 378. Hyattsville, MD: National Center for Health Statistics. 2020. https://www.cdc.gov/nchs/products/databriefs/db378.htm
Wongpakaran, N., et al. (2021). Trends in anxiety symptoms among adults in Thailand: Results from the National Mental Health Survey 2014-2020. Asian Journal of Psychiatry, 64, 102735. DOI: 10.1016/j.ajp.2021.102735
World Health Organization. COVID-19 pandemic triggers 25% increase in prevalence of anxiety and depression worldwide. 2022. https://www.who.int/news/item/02-03-2022-covid-19-pandemic-triggers-25-increase-in-prevalence-of-anxiety-and-depression-worldwide
Zald, M. N., & McCarthy, J. D. (1979). The resource mobilization perspective. Annual Review of Sociology, 6(1), 479-502. DOI: 10.1146/annurev.so.06.080180.002403
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