Adaptation of child focused cognitive behavior therapy as an intervention program

Abstract

Child-focused cognitive behavioral therapy (CF-CBT) is a treatment approach which is based on evidence. The purpose of this therapy is to help children, adolescents, and their parents (or other caregivers) overcome child-related difficulties. These difficulties include anxiety, anger, maladaptive behavior, negative irrational thinking process etc. As far as Bangladesh is concerned, more often than not, western values influence cognitive behavioral therapy (CBT) since it was primarily developed and practiced in the West. Cultural understanding and contextualizing have always led to a better therapy outcome. Many a researcher have suggested that CBT need modification and adaptation to non-western clients‘ cultural and social backgrounds. In Bangladesh, there is a scarcity of organized and systematic intervention programs in Bangla. In that case, applying and developing interventions for Bangladeshi culture to serve the affected children is of vital importance. It is the necessity of the time to adapt the intervention culturally. The main objectives of the present study were to adapt the Child Focused Cognitive Behavior Therapy as an intervention for children and assess the effectiveness of adapted Child Focused Cognitive Behavior Therapy as an intervention. To attain these two objectives, the research has been divided in two sections (section 1 & 2). Section 1 was constructed for general objective 1 and five specific objectives were administered to fulfill the general objective 1. General objective 2 was administered in section 2 with 3 specific objectives. Again, the researcher has divided section-1 in two phases (Phase 1 & 2). To accomplish the phase 1, a number of child focused activities were selected, translated and reviewed. 20 regular random children were taught some Dhaka University Institutional Repository Adaptation of child focused CBT techniques. These children also practiced the activities in several sessions. With their feedback and psychologists‘ constructive opinion by credibility questionnaires, bangla activities were reviewed and re-constructed which was the researcher‘s draf-2. In phase 2, purposively selected 10 children were skilled with draft-2. After their comments and review, draft-3 was developed. In the section 2, draft-3 was applied on 49 children, who the researcher has termed as Case Group, with extremely elevated or moderately elevated anxiety and anger. There were 3 control groups. Control Group-1 did not receive any intervention; they also did not come to the hospital for their own treatment purpose. Control group-2 and 3 were already assessed by other psychologists. There were extremely elevated or moderately elevated anxiety and anger in these children and they received intervention by general instruction and creative therapy respectively. 49 children from Case group, 28 children from control group 2 and 30 children from control group 3, all attended 14 sessions in 14 weeks. The time duration was 1 hour 30 minutes for each of the sessions. So, the total number of the sessions were 1498 (107 participants multiplied by 14 sessions). By comparing the mean score by t value, the researcher saw that among all the groups, the mean score of anxiety and anger level in the Case Group is the lowest than 3 control groups. Also, the credibility questionnaire percentage among the children, parents and psychologists proved that the child focused CBT Bangla activities, which were developed by the researcher, were more effective in reducing anger and anxiety among the children. So, the researcher finally deduced that these CBT Bangla activities could be used in a larger scale throughout the nation.