Development of Modified Cognitive Behaviour Therapy in Sri Lanka: a feasibility study

Abstract Introduction- Depression is an important public health issue in Sri Lanka with a high prevalence and significant burden. Depression is under-treated in Sri Lanka. Psychotherapy, an integral part of the treatment, is rarely practiced in the country, partly due to lack of culturally sensitive psychotherapies. Method- An experimental prospective study design was adopted to evaluate the feasibility and safety of modified cognitive behavioural therapy (CBT). Twelve consenting adult patients with depressive disorder received 6 sessions of modified CBT over 10 weeks and were followed-up for 16 weeks thereafter. Participants were assessed with Hamilton Depression (HRSD) and Beck Depression (BDI) and Global Assessment of Function (GAF) scales. Interviews were conducted with patients and clinicians regarding the acceptability of treatment. Results- Eleven out of 12 patients completed the treatment. HRSD, BDI and GAF scores improved significantly (p>0.05) from baseline to both week 10 and 26. All the patients believed that the psychotherapy was useful while all the clinicians reported modified CBT as being feasible and easily deliverable. Conclusion- Culturally modified CBT for depression is acceptable, feasible and probably effective.