On developing a culturally adapted CBT model: A qualitative investigation on the experiences of Kenyan counsellors using the CBT 5 aspects model with their clients

The research focused on the experiences of Kenyan counsellors using the CBT 5 aspects model with a commitment to encouraging Afrocentric values and supporting the decolonising of methodologies movement. The methodological design uses a qualitative enquiry using reflexive thematic analysis (Braun & Clarke, 2013) to analyse the data. A focus group method was chosen. The participants reported positive use of the CBT 5 aspects model but reported complexity when eliciting thoughts and feelings from their clients via English, Kiswahili, and mother-tongue dialects. Difficulties arose using the CBT 5 aspects model in Kenya with clients, especially men, who were traditionally and culturally socialised and experienced the model as coercive and too directive. The question of how the 5 aspects model was initially introduced in the counselling session was seen to be critical, as this is when you can “win or lose” your client. It was seen to be necessary for counsellors to have a clear understanding and good enough knowledge of the model so that its delivery could aim to be parsimonious and understood. A clear explanation of the model to the client was also noted to be important. The usage of African-representational emojis to depict the represented areas within the model around cognition, emotion, physical sensations, and behaviours was also encouraged. Participants reported that storytelling or ‘off-loading’ of their clients’ issues was culturally practiced at the onset of sessions, and it was suggested that space for storytelling at the onset was upheld. Clear evidence emerged that the CBT 5 aspects model can be clinically effective in Kenyan culture, but only if it is culturally attuned to the native population and divested of its colonial and oppressive assumptions.