What Are the Experiences of the Journey in an Improving Access to Psychological Therapies Service for Individuals in the Afghan Community?

The aims of the study were to explore the experiences of manualised CBT within IAPT services from an Afghan persons experiences. The study sought to understand the depths of the experiences through a cultural lens, with the goal of offering insights to Counselling Psychologists and psychological professionals on how to work with Afghans within IAPT, and a wider hope to offer suggestions for service improvements to enhance an Afghan persons experiences with therapy. There were five female participants aged between 21-35. I conducted semi-structured interviews which were analysed with Reflexive Thematic Analysis. Three overarching themes were presented in the context of a journey: The beginning, the middle and the end. Within each overarching theme were two to four themes and one to five subthemes.

The research found experiences with therapy could be more empowering if IAPT environments facilitate choice, shared decision making and a genuine curiosity about the cultural aspects of being Afghan. Choice refers to how much involvement a person has when allocated a therapist (with discussions around gender, cultural background and modality of therapy, i.e., face to face or online). Participants felt better able to engage when they felt they could relate to their therapist, whilst also gaining a sense that their therapist could relate to them and understand their difficulties through a cultural lens. Contrary to this, the data also suggested that a lack of cultural similarity could also create safety in an Afghan’s engagement with CBT within IAPT. Detriments in care tended to relate to wait times, a lack of rapport between therapist and participant and difficulties engaging with the manualised CBT techniques.

Suggestions are made about offering choice and understanding the context of an Afghan’s woman’s journey during therapy. Cultural competence is considered, and this research expands on this by discussing how IAPT could go beyond cultural competence and consider cultural humility as a way to combat a lack of cultural curiosity and unconscious biases when working with minority groups.

Recommendations for future research whilst considering the epistemic and ontological gaps in the research which are also addressed through my own ontological and epistemological choices for the current research.