Feasibility study for assessment of culturally adapted Behavioural Activation for the treatment of depression

Background: There is evidence that culturally adapted psychotherapies (CAPs) are more effective for treating mental illnesses than standard therapies, but further research is needed to evaluate efficacy of CAPs focusing on the treatment of depression. Behavioural Activation (BA), an existing evidence-based treatment for depression, has been culturally adapted for depressed Muslims in the UK (BA-M; Mir et al., 2015). BA-M has the potential to be beneficial for the treatment of depression in Turkey, which is a Muslim majority country, but this has not yet been evaluated.

Aims: The primary aim of this thesis was to examine the feasibility of conducting a full Randomised Controlled Trial (RCT) of BA-M for depressed Muslim adults in Turkey. A secondary aim was to compare findings of the feasibility study in Turkey with those obtained from the UK pilot study.

Research design: Three studies were conducted: (1) a systematic review and meta-analysis of face-to-face CAPs; (2) a mixed methods parallel group feasibility study of BA-M compared to Cognitive Behavioural Therapy (CBT); and (3) a comparison study based on findings from the pilot study of Mir et al. (2015) with findings from the feasibility study.

Results: The meta-analysis found that CAPs result in a statistically significant reduction in depressive symptoms for depressed adults compared with control conditions with a standardised mean difference of 0.63 standard deviations.

Quantitative and qualitative findings from the feasibility study provided evidence about acceptability of BA-M among depressed clients and their therapists in Turkey and that the feasibility study was partially successful, thus an RCT of BA-M could be feasible if issues regarding clients’ recruitment and data collection are addressed.

The comparison study found some similarities and differences between treatment acceptability and outcome of BA-M among Muslim clients and therapists in Turkey compared to those in the UK.