Using cognitive behaviour therapy with South Asian Muslims: Findings from the culturally sensitive CBT project
Open accessAbstract
It has been suggested that cognitive behaviour therapy (CBT) needs adaptation for it to be effective for patients from collectivistic cultures, as currently CBT is underpinned by individualistic values. In prior studies we have demonstrated that CBT could be adapted for Pakistani patients in Southampton, UK, and for local populations in Pakistan. Findings from these studies suggest that CBT can be adapted for patients from collectivistic cultures using a series of steps. In this paper we focus on these steps, and the process of adapting CBT for specific groups. The adaptation process should focus on three major areas of therapy, rather than simple translation of therapy manuals. These include (1) awareness of relevant cultural issues and preparation for therapy, (2) assessment and engagement, and (3) adjustments in therapy. We also discuss the best practice guidelines that evolved from this work to help therapists working with this population. We reiterate that CBT can be adapted effectively for patients from traditional cultures. This is, however, an emerging area in psychotherapy, and further work is required to refine the methodology and to test adapted CBT.
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Cognitive behavioural therapy approaches may be less acceptable and harder to integrate into daily life for patients from collectivist cultures.
“and less acceptable and more difficult to incorporate into daily lives in patients from 'collectivist' cultures (where networks, kinship and the roles they bring are very important and goals are pursued within those constraints) (Naeem et al., 2015).”
From Efficacy, acceptability and safety of cognitive behavioural therapies in fibromyalgia syndrome – A systematic review and meta-analysis of randomized controlled trials (2018) · cites this paper as Naeem et al., 2015
Cognitive behavioural therapy approaches may be more acceptable and easier to implement in Western individualist cultures.
“CBTs approaches may be more acceptable and easier to implement in western populations whose cultures are 'individualist' (where individual self-realization is everything and relationships with family and others are subordinate)”
From Efficacy, acceptability and safety of cognitive behavioural therapies in fibromyalgia syndrome – A systematic review and meta-analysis of randomized controlled trials (2018) · cites this paper as Naeem et al., 2015
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“Our results agree with existing literature on cultural adaptation (Barrio & Yamada, 2010; Edge et al., 2016; Naeem et al., 2015).”
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Cultural Adaptation of Cognitive Behavioural Therapy
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Self-citationIrfan, B., Attarian, H. P., Irfan, M., Sankari, A., Kirschner, D. E., & Khan, M. S. (2025) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2025.102138 · Cited by 6 · see citing works
Dignity is the method: ethnic minority mental health, structural harm, and the constellation model
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Pakistani Immigrants' Nuanced Beliefs About Shame and Its Regulation
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Reich, M., Jarvis, G. E., & Whitley, R. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-05940-8 · Cited by 8 · see citing works
“Furthermore, these trainings can also discuss how clinicians can culturally-adapt evidence-based clinical tools such as cognitive behavioural therapy so that they are more appropriate and relevant for Muslim patients; an emerging yet promising practice in psychotherapy [67].”
BackgroundHusain, M. I., Umer, M., Asif, M., Khoso, A. B., Kiran, T., Ansari, M. A., Aslam, H., Bhatia, M. R., Dogar, F. A., Husain, M. O., et al. (2022) · BJPsych Open · doi:10.1192/bjo.2022.598 · Cited by 5 · see citing works
“26,27 Most cultural adaptations of psychological treatments tend to be for implementation rather than content, 28 and we use the same principle for the CaPE intervention.”
Self-citationThe negative side of Culture-based CBTs: An example from India
Selvapandiyan, J. (2020) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2020.102036 · Cited by 4 · see citing works
Spiritually-Oriented Cognitive-Behavioral Family Therapy
TURGUT, T., & Ekşi, F. (2020) · Spiritual Psychology and Counseling · doi:10.37898/spc.2020.5.1.095 · Cited by 4 · see citing works
Glowacki, C. R., & Glowacki, Z. R. (2021) · Clinical Case Studies · doi:10.1177/15346501211011255 · Cited by 4 · see citing works
“This style was consistent with recommendations from the literature regarding directive and collaborative style of therapy with PA patients (Hall et al., 2018; Naeem et al., 2015).”
BackgroundResultInfluentialMamani-Benito, O., Esteban, R. F. C., Castillo-Blanco, R., Lingán-Huamán, S. K., Fernández, J. P., & Vizcarra, M. P. (2020) · Revista Digital de Investigación en Docencia Universitaria · doi:10.15562/bmj.v9i3.2028 · Cited by 4 · see citing works
Culture Free CBT for Diverse Groups
Phiri, P., Clarke, I., Baxter, L., Elliot, K., Rathod, S., & Naeem, F. (2021) · IntechOpen eBooks · doi:10.5772/intechopen.93904 · Cited by 4 · see citing works
Self-citationPerspectivas metodológicas de la investigación en salud pública, breve mirada
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A Qur'anic Concept of Sadness: Implication for CBT-Q Content Supplement (Part 1)
Abas, N. A. B. (2021) · ULUMUNA · doi:10.20414/ujis.v25i1.438 · Cited by 3 · see citing works
Chaudhry, N., Farooque, S., Kiran, T., Eylem, Ö., Chaudhry, I. B., Memon, R., Husain, M., Andriopoulou, P., Rana, M. H., Naeem, F., et al. (2022) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2021.42 · Cited by 3 · see citing works
“, 2014b, 2017b, 2020), including a cultural adaptation of interventions (Naeem et al., 2015).”
BackgroundMethodSelf-citationCulturally Competent Occupational Therapy Practice for South Asians in the United States of America
Vij, S. B., & Webb, M. L. (2022) · The Indian Journal of Occupational Therapy · doi:10.4103/ijoth.ijoth_59_21 · Cited by 3 · see citing works
Depression and Anxiety in Refugee Children
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Khan, N., Butt, M. G., Awan, F., Abid, S., Latif, M., Aslam, M., Naz, S., Phiri, P., Zadeh, Z. F., Farooq, S., et al. (2025) · BMJ Mental Health · doi:10.1136/bmjment-2024-301389 · Cited by 3 · see citing works
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Islam, F., Qasim, K., Qutub, A., Ali-Mohammed, S., Abdulwasi, M., Shakya, Y. B., Hynie, M., & McKenzie, K. J. (2024) · International Journal of Migration Health and Social Care · doi:10.1108/ijmhsc-04-2024-0046 · Cited by 2 · see citing works
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Psychological Models of Health
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CBT for anxiety disorders among children in Pakistan
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Culturally Adapted CBT for Psychosis
Naeem, F., Naz, S., & Phiri, P. (2023) · Springer eBooks · doi:10.1007/978-3-031-27003-1_7 · Cited by 1 · see citing works
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Challenges in developing feasible and cost-effective therapies for use in LMICs
Naeem, F., Rathod, S., Khan, N. S., & Ayub, M. (2016) · The British Journal of Psychiatry · doi:10.1192/bjp.209.3.263a · Cited by 1 · see citing works
Self-citationYusuf, H. (2019) · TSpace (University of Toronto) · Cited by 1 · see citing works
Dandgey, S. (2018) · London Met Repository (London Metropolitan University)
An Analysis of 100 Muslim Email Counseling Clients
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Psychosocial Interventions in Rehabilitation: An Intercultural Perspective
Aly, R., Naeem, F., & Javed, A. (2019) · Springer eBooks · doi:10.1007/978-3-030-24082-0_25
Self-citationSomnological findings based on the Körmend Growth Study (2008) data (Hungary)
Buda, B. L., Marksz, L., & Tóth, G. (2020) · Papers on Anthropology · doi:10.12697/poa.2020.29.1.01
Nurse, K. (2020) · UEL Research Repository (University of East London) · doi:10.15123/uel.88wvy
“The CBT adaptation process should focus on increased awareness of cultural factors, improving assessment and engagement, and adjusting therapy to focus on the client’s concerns and connecting these to their therapeutic goals (Naeem et al., 2015).”
BackgroundSexual and Gender Minority Youth’s Mental Health and Substance Use
Kiekens, W. J. (2022) · doi:10.33612/diss.230804866
Okoye, G., Ben‐Umeh, K. C., Okoye, V., Osuji, S., & Vincent, R. (2022) · International Neuropsychiatric Disease Journal · doi:10.9734/indj/2022/v18i2347
Ethno-cognitive behavioral therapy and ethnopsychotherapy: A new narrative
Naeem, F. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-85726-0.00018-1
Self-citationAbdi, S. K., Syed, A. A., Butt, A., & Batool, S. (2023) · JAIMC Journal of Allama Iqbal Medical College · doi:10.59058/jaimc.v20i3.67
An Intersectional Feminist Approach to Pakistani-American Women’s Gender Roles in Therapy
Thornhill, C. W., Ali, S. F., & Castillo, L. G. (2023) · International Journal for the Advancement of Counselling · doi:10.1007/s10447-023-09539-8
“…figures, counselors can avoid confusion or miscommunication by making it explicit that voicing conflicting opinions is encouraged in therapy, monitoring clients’ nonverbal communication, and checking in with clients about whether they agree with the counselor’s assertions (Naeem et al., 2015).”
InfluentialNasim, S., Lowe, N. M., Moran, V. H., Dillon, S., & Zaheer, S. (2024) · Khyber Medical University Journal · doi:10.35845/kmuj.2024.23452
Formulation Considerations for Individuals Experiencing Emotional Distress and Substance Use
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Parent Involvement in Weekly Outpatient Treatment
West, A. E., & Conn, B. M. (2024) · CBT: science into practice · doi:10.1007/978-3-031-74838-7_8
Mucić, D., & Hilty, D. M. (2024) · Springer eBooks · doi:10.1007/978-3-031-59936-1_1
Kendrick, T., Stuart, B. L., Bowers, H. M., Sadeghi, M. H., Hl, P., Dowrick, C. F., Moore, M. V., Gabbay, M., Leydon, G., Yao, G., et al. (2025) · Programme Grants for Applied Research · doi:10.3310/btbl3945
Khalid, H., Hassan, S. M. U., Malik, T. A., Tariq, I., Waseem, T., Barrett, P. M., & Lau, C. Y. (2026) · Child and Adolescent Social Work Journal · doi:10.1007/s10560-026-01091-9
“While several evidence-based programs, such as CBT-based treatments for depression (Naeem et al., 2015), Barkley’s parent training (Malik et al., 2017), and Coping Power for aggression management (Mushtaq et al., 2017), have been successfully adapted and implemented in Paki-stan and other LMICs,…”
Mushtaq, R., Rabbani, A., & Lodhi, M. K. (2025) · Mental Health Religion & Culture · doi:10.1080/13674676.2025.2507394
“…medications over therapy due to certain cultural and traditional beliefs, seeing medicines as a tangible treatment, accessibility and cost issues (Naeem et al., 2015) In addition to the modified versions of intervention paradigms inculcating Islamic principles, listening to Holy Quran scriptures…”
Fu, K., Iwamoto, M., Chang, E., Dao, L., Zheng, M., Xu, K., Chan, C., Tang, A., & Nemoto, T. (2026) · Journal of Behavioral Medicine · doi:10.1007/s10865-026-00674-2
“Given that non-adapted CBT often emphasizes individualistic values, there is a need for cultural adaptation when applied to clients from more collectivistic cultures, such as with AAAIs (Hwang, 2026 ; Naeem et al., 2015 ).”
South Asian youth perceptions of standard and culturally adapted cognitive behavioural therapy
Nair, R., Naeem, F., & Aitken, M. (2026) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2026.2706580
Self-citationHusain, M. I., Asif, M., Khoso, A. B., Umer, M., Shakoor, S., Kiran, T., Tahir, M. R., Rajput, A. H., Saqib, M., Husain, M. O., et al. (2026) · EClinicalMedicine · doi:10.1016/j.eclinm.2026.104271
Self-citation
- Authors
- Naeem, F., Phiri, P., Munshi, T., Rathod, S., Ayub, M., Gobbi, M., & Kingdon, D.
- Affiliations
- Queen's University (CA)
- University of Southampton (GB)
- Queens University, Kingston, Canada
- Corresponding author
- Naeem, Farooq
- Venue
- International Review of Psychiatry
- Publisher
- Informa UK Limited
- Published
- 2015-05-04
- Volume
- 27
- Issue
- 3
- Pages
- 233-246
- ISSN
- 0954-0261 (ISSN-L)
- 1369-1627
- OpenAlex
- W1809552735
- Cited by
- 84
- References
- 61
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 8 · 2023: 10 · 2022: 9 · 2021: 12 · 2020: 10 · 2019: 12 · 2018: 5 · 2017: 6 · 2016: 2 · 2015: 1
- FWCI
- 15.48
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- International Review of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- PubMed
- Topics
- Social Sciences › Sociology and Political Science › Cultural Competency in Health Care
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Social Psychology › Counseling Practices and Supervision
- Keywords
- cognitive behavioral therapy, cultural adaptation of psychotherapy, South Asian Muslims, Pakistani patients, collectivist culture, individualism, treatment engagement, traditional culture
- MeSH terms
- Adult, England, Humans, Islam, Pakistan, Cognitive Behavioral Therapy, Practice Guidelines as Topic, Culturally Competent Care
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