There are 2.6 million people of South Asian origin in Canada, making it the largest racialized group in the country. Although this population has higher rates of anxiety and mood disorders, it is also 85 per cent less likely to seek treatment due to many factors, including socioeconomic disparities, cultural differences and stigma.
That is why the Centre for Addiction and Mental Health (CAMH) alongside the Mental Health Commission of Canada (MHCC) and community partner organizations nationwide has created a new specialized training resource for mental health professionals to assist in providing evidence-based mental health supports to people of South Asian origin in Canada. Specifically, these new training resources provide guidance for clinicians of all backgrounds on how to implement a new form of culturally adapted cognitive behavioural therapy (CBT) created specifically for this population, as well as supplementary information for patients.
Sidra Mobin experienced symptoms of anxiety after she moved from her native Pakistan to Vancouver. When a friend forwarded her a flier she saw at a local help centre for a CAMH study that was recruiting people of South Asian origin with lived experience of mental illness to receive this new form of treatment, she volunteered to enroll in the study.
"When I started I did not even know if I needed this type of therapy," says Sidra. “Now that I have gone through this program I know that this works way better than any other therapy I have tried. It's a process and the journey continues, but I definitely feel more like myself than before I started this therapy."
The study, Culturally Adapted Cognitive Behavioural Therapy for Canadians of South Asian Origins involved 146 participants of South Asian descent in Vancouver, Ottawa and Toronto receiving 8-12 sessions of either standard CBT, or a specialized version of culturally adapted CBT (CaCBT) developed for people of South Asian origin. Researchers found that while both forms of CBT were effective in reducing symptoms of depression and anxiety, participants who got the CaCBT benefitted the most.
"CBT is the most popular form of evidence-based therapy that exists," Principal Investigator Dr. Farooq Naeem, CAMH Clinician Scientist at the Campbell Family Mental Health Research Institute. "This new culturally adapted CBT also takes into account a person's cultural background and is modified to better fit the patient's beliefs, language, and cultural context. This study found that in terms of acceptance and effectiveness, culturally adapted CBT works even better for this population."
When treating depression and anxiety, many therapists will turn to cognitive behavioural therapy (CBT), an evidence-based psychological treatment that focuses on changing people's negative thoughts and beliefs. However, CBT was developed in a Western context, and has proven to be not as effective with those of different backgrounds. In 2019, CAMH received funding from the Health Canada Health Care Policy Contribution Program to develop, test and evaluate new mental health supports for South Asian populations in Canada. CAMH also worked closely with partners MHCC, Moving Forward Family Services (Vancouver), Ottawa Newcomer Health Centre (Ottawa) and Punjabi Community Health Services (Greater Toronto Area) as part of this initiative.
"One of the important things about this work and the training available in CaCBT for the South Asian population—or indeed the Caribbean origin population through the CAMH Health Equity Department—is it signals to therapists that we cannot use simple one-size-fits-all treatments in a diverse country like Canada," said Co-Principal Investigator Dr. Kwame McKenzie, Director of Health Equity at CAMH. "We sometimes need different interventions for different groups of people. Equity requires therapeutic flexibility."
Dr. McKenzie comments were echoed by study participant Registered Psychotherapist Helen Yohannes, who received specialized training in CaCBT for people of South Asian origin.
"As a child of refugee parents, I always saw that there were huge gaps in treatment for racialized populations in Canada," says Yohannes. “This training made me a better therapist and opens me up to a wider range of clients. Now that more people are opening themselves up to therapy, we have to be prepared to see everybody and not just one type of client."
The research team is currently seeking government funding for a national training program of clinicians in CaCBT based on the training created for this study.
"CAMH was a pioneer in this work and now leads nationally and internationally in the study and implementation of CaCBT among several populations," added Dr. Naeem. "As a diverse country with an ongoing mental health crisis, we need options for care that honour people's cultural values, beliefs and life experiences. We are proud to offer today proven, effective mental health care resources that can make a real impact for millions of people Canada-wide."