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Cultural adaptation and preliminary evaluation of the psychosis REACH family intervention in Pakistan

Title: Cultural adaptation and preliminary evaluation of the psychosis REACH family intervention in Pakistan
Authors: Sarah L. Kopelovich; Shanaya Rathod; Jennifer Blank; Rehmeena Iqbal; Akansha Vaswani-Bye; Douglas Turkington; Kate Hardy; Imran I. Haider; Victoria Shepard; Peter Phiri; Afzal Javed
Source: Cambridge Prisms: Global Mental Health, Vol 13 (2026)
Publisher Information: Cambridge University Press
Publication Year: 2026
Collection: Directory of Open Access Journals: DOAJ Articles
Subject Terms: family interventions for psychosis; task-shifting; psychosis REACH; cultural adaptations; CBTp; low-and middle-income countries; feasibility study caregiver burden; Neurosciences. Biological psychiatry. Neuropsychiatry; RC321-571
Description: Most individuals with mental disorders reside in low- and middle-income countries (LMICs), where care is often provided by family members. However, Family Interventions for psychosis (FIp) are rarely adapted for LMIC contexts. Using a validated cultural adaptation framework, we adapted Psychosis Recovery by Enabling Adult Carers at Home (Psychosis REACH) – an intervention designed for delivery outside of clinical settings – and evaluated the adapted version (Ca-REACH) among families affiliated with a mental health rehabilitation clubhouse in Lahore, Pakistan. A Fountain House clinician delivered Ca-REACH to 40 caregivers of individuals with psychosis through eight in-person group sessions. Feasibility was demonstrated across multiple process indicators: all 40 caregiver–resident dyads consented (100% recruitment), caregiver retention was high, session attendance averaged 96.5% and assessments were completed at baseline, post-intervention and 4-month follow-up. Data completeness among residents was 85%. Perceived feasibility, acceptability and appropriateness (FIM, AIM, IAM) all exceeded the benchmark score of 4.0 (M = 4.42–4.79). Caregivers demonstrated significant improvements in anxiety and psychological well-being, with marginal reductions in depression. Residents showed significant improvements in PANSS general and total symptom scores. Findings support the acceptability and promise of Ca-REACH as a feasible, culturally responsive, community-delivered FIp in a low-resource setting.
Document Type: article in journal/newspaper
Language: English
ISBN: 978-2-05-442512-1; 2-05-442512-5
Relation: https://www.cambridge.org/core/product/identifier/S2054425125101076/type/journal_article; https://doaj.org/toc/2054-4251; https://doaj.org/article/a70d059813204eb7a2580362a29dcf53
DOI: 10.1017/gmh.2025.10107
Availability: https://doi.org/10.1017/gmh.2025.10107; https://doaj.org/article/a70d059813204eb7a2580362a29dcf53
Accession Number: edsbas.FC35B879
Database: BASE