Background to the development of this intervention

Development of the Manual

This intervention has been developed in response to a number of policy statements and guidelines that promote the use of culturally appropriate treatment for service users from minority ethnic and faith groups (WHO, 2018; NICE, 2009, 2022; Department of Health 1999; Department of Health, 2005). Reviews of clinical trials and interventions provide little evidence about minority religious groups (Townsend et al., 2001), and detailed descriptions of the form and content of interventions for Muslim clients are not generally available (Azhar and Varma, 1995). More evidence is therefore needed about the effectiveness of culture-sensitive models of therapy and treatment outcome data is needed to assess whether these yield better results with specific religious groups than standard therapies (Hook et al., 2010).

An Introduction to the Development of the Manual

Interventions that draw on faith can be effective in addressing and preventing depression (Lipsker and Oordt, 1990; Kumar, 2006; Barron, 2008) and improving quality of life (Lee et al., 2010). Religious coping strategies for depression have been integrated into:

• counselling (Chandrashekar, 2007; Glueckauf et al., 2009)
• acceptance and commitment therapy (Hayes, 2004)
• energy psychology approaches (Brockman, 2006)
• cognitive behavioural therapy (Lipsker and Oordt, 1990; Propst et al., 1992; Satterfield, 2002; Scott, 2003; Randall, 2004; Barron, 2008; Paukert et al., 2009)
• treatment of depression in cancer and terminally-ill patients (Cole, 2000; Reyes, 2003), and those who have experienced trauma (Kelly, 2007) and torture (Leaman, 2009)

[Production note: in the source version, this section is presented as a drag-and-drop exercise matching religious coping strategies to the therapy types above. Simplified here to a list.]

Video: Tips and Rationale for Using BA-M with Muslim Clients from the Perspective of CBT Therapists

The video below gives a rationale for using the BA-M approach from the perspective of CBT therapists.

[Production note: original video not yet ported; transcript of the narration below.]

Project focuses on people from Muslim backgrounds because there is evidence that some people within Muslim communities experience higher levels of depression, which are more chronic in nature than in the general population. Muslim clients are also more likely to use religious coping techniques than individuals from other religious groups in the UK. This is therefore a potentially important focus for culturally appropriate mental health treatments. There is a significant body of literature which shows that religion may influence well being through pathways that are behavioural, psychological, social, and physiological. This literature identifies a distinction between negative religious coping, such as feeling abandoned or punished by God, or unsupported by one's religious community and positive religious coping. The former can increase depression and anxiety and pain severity for people with physical illnesses. Positive religious coping, on the other hand, is associated with reduced levels of depression and the use of an internalised spiritual belief system to provide strategies that promote hope and resilience. Religious beliefs and practises that encourage a proactive approach to dealing with problems rather than relying on divine intervention are also more likely to help people overcome depression.

There is evidence that this approach is significantly more effective in treating depression in Muslims than standard CBT or social interventions (Dawood et al., 2023 and Mir et al., 2023).

[Production note: the source version also includes a video testimonial from a service user named Khalid; its content has not yet been captured for this draft.]