ABSTRACT
OBJECTIVE: Common mental disorders constitute a considerable disease burden in low-income countries, and there is a need for acceptable and effective brief interventions for such disorders in low-income countries. This article examines cultural based interpretations of the diagnosis of panic disorder (PD) in a rural Tanzanian hospital setting through clinical work. It also examines how to adapt and apply brief cognitive behaviour therapy (CBT) interventions to this setting. METHOD: A qualitative analysis of clinical data from ten participants in a hospital-setting in rural Tanzania. RESULTS: The analysis suggests that the diagnosis of PD is relevant to this rural Tanzanian setting. Patients, relatives, and health personnel at the hospital accepted brief CBT interventions for PD and regarded psychoeducational information to patients as especially useful. CONCLUSION: A manual for brief interventions for PD may be adapted to a rural Tanzanian setting, also taking into consideration the limited financial and human resources in a rural low-income country setting.
Subject(s)
Cognitive Behavioral Therapy/methods , Panic Disorder/diagnosis , Panic Disorder/therapy , Adult , Culture , Female , Humans , Male , Middle Aged , Patient Education as Topic/methods , Psychotherapy, Brief/methods , Rural Population , Tanzania , Treatment Outcome , Young AdultABSTRACT
Internet-based self-help with therapist guidance has shown promise as an effective treatment and may increase access to evidence-based psychological treatment for social anxiety disorder (SAD). Although unguided self-help has been suggested primarily as a population-based preventive intervention, some studies indicate that patients with SAD may profit from unguided self-help. Gaining knowledge about predictors of outcome in guided and unguided self-help for SAD is important to ensure that these interventions can be offered to those who are most likely to respond. Utilizing a sample of 245 patients who received either guided or unguided self-help for SAD, the present study examined pre-treatment symptoms and program factors as predictors of treatment adherence and outcome. The results were in line with previous findings from the face-to-face treatment literature: namely, the intensity of baseline SAD symptoms, but not depressive symptoms, predicted treatment outcomes in both unguided and guided self-help groups. Outcomes were unrelated to whether a participant has generalized versus specific SAD. Furthermore, for the unguided self-help group, higher credibility ratings of the treatment program were associated with increased treatment adherence. The findings suggest that guided and unguided self-help may increase access to SAD treatment in a population that is more heterogeneous than previously assumed.
