‘I went back to being myself’: acceptability of a culturally adapted task-shifted cognitive-behavioural therapy (CBT) treatment for depression (Ziphamandla) for South African HIV care settings
Open accessAbstract
There is a need for a culturally adapted, evidence-based, psychotherapy treatment that is effective, acceptable, and feasible for integration into primary care in South Africa. This qualitative study used exit interviews to examine participants' experiences of an adapted cognitive-behavioural therapy treatment for adherence and depression, task-shifted and delivered by nurses in two peri-urban HIV clinics near Cape Town. Nine semi-structured exit interviews were conducted with isiXhosa-speaking females and analysed using thematic analysis. Overall, participants responded positively to the treatment, viewing it as acceptable and beneficial and as a catalyst to returning to normalcy. Results indicated that participants viewed the treatment as being effective in ameliorating their depressive symptoms and improving their adherence to ART . Additional benefits described included improvements in subjective wellbeing and social and occupational functioning. Several began or resumed employment, an important behavioural indicator of the treatment's capacity to facilitate positive change and cost saving. Recommendations to improve the treatment included using video material and educating others about depression. These findings have positive implications regarding the acceptability and cultural applicability of the treatment for use in South Africa.
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Providers with increased self-efficacy were more successful in establishing trust with clients and impacting meaningful change.
“with such providers possessing increased self-efficacy, more successful in establishing trust with clients, and impacting meaningful change [50, 71].”
From Barriers and facilitators to implementation of evidence-based task-sharing mental health interventions in low- and middle-income countries: a systematic review using implementation science frameworks (2022) · cites this paper as [71]
In Results > Acceptability (page unavailable), participants described the nurse providers as trustworthy and reported positive changes in their lives. The Conclusion (page unavailable) describes mutually respectful therapist relationships and perceived improvements after treatment. The paper does not report increased provider self-efficacy or establish that self-efficacy made providers more successful at building trust or producing change. (LLM, conf=0.86)
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References 25 · Cited by 21
- Authors
- Everitt-Penhale, B., Kagee, A., Magidson, J. F., Joska, J., Safren, S. A., O’Cleirigh, C., Witten, J., Lee, J. S., & Andersen, L. S.
- Affiliations
- Stellenbosch University (ZA)
- University of Maryland, College Park (US)
- University of Cape Town (ZA)
- University of Miami (US)
- Harvard University (US)
- Corresponding author
- Andersen, L. S.
- Venue
- Psychology, Health & Medicine
- Publisher
- Informa UK Limited
- Published
- 2019-01-17
- Volume
- 24
- Issue
- 6
- Pages
- 680-690
- ISSN
- 1354-8506 (ISSN-L)
- 1465-3966
- PMC
- PMC6484450
- OpenAlex
- W2909416771
- Cited by
- 21
- References
- 25
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 4 · 2023: 7 · 2022: 2 · 2021: 2 · 2020: 1
- FWCI
- 1.57
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Psychology Health & Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- SUNScholar (Stellenbosch University) (submittedVersion)
- Funders
- National Institute of Mental Health (R01MH103770)
- U.S. President's Emergency Plan for AIDS Relief (9K24DA040489,K23DA041901)
- National Institute of Drug Abuse (9K24DA040489,K23DA041901)
- Wellcome Trust (084323/Z/07/A)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Keywords
- depression, HIV, antiretroviral therapy adherence, culturally adapted psychotherapy, treatment acceptability, primary care integration, return to work, subjective well-being, South Africa
- MeSH terms
- Adult, Depression, Female, Humans, Middle Aged, Patient Acceptance of Health Care, Pilot Projects, Primary Health Care, South Africa, HIV Infections, Cognitive Behavioral Therapy, Treatment Outcome, Qualitative Research, Young Adult, Culturally Competent Care
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