Attitudes of Mental Health Professionals Toward Digital Cognitive Behavioral Therapy in Pakistan

Dr. Aatir Hanif; Rabia Waqar Khan; Laiba Hayat; Arella Chan; Flahat Maqbool; Nabeel Shakir

Dr. Aatir Hanif Liaquat University of Medical and Health Sciences
Rabia Waqar Khan Director Mind and Connect
Laiba Hayat Hayat Embodied Therapy
Arella Chan University of Torronto
Flahat Maqbool Sindh Institute of Physical Medicine and Rehabilitation
Nabeel Shakir University of Karachi

Keywords: digital CBT, teletherapy, e-mental health, Pakistan, therapist attitudes, cognitive behavioral therapy, mental health professionals

Abstract

Background: Digital mental health services are growing at a swift pace around the world, and there is an urgent need to understand the attitudes of professionals towards technology-assisted psychological treatments in low and middle-income countries. This study explored the attitudes of mental health professionals in Pakistan towards digital Cognitive Behavioral Therapy (CBT), which is the use of internet platforms or mobile applications to provide CBT.

Methods: A cross-sectional survey design using a quantitative approach was used. There were 80 mental health professionals (clinical psychologists, counsellors and psychiatrists) who participated (Mage = 36.32, SD = 9.91). A 31 items instrument developed by the researchers measured seven domains of the attitudes. The instrument assessed seven domains: knowledge and training, perceived effectiveness and clinical confidence, cultural fit and contextual adaptation, online therapeutic alliance, digital literacy and technology confidence, workload/supervision/professional support, and willingness to implement/perceived barriers. Frequency distributions and valid percentages were used to analyse the data.

Results: Results showed positive attitudes overall, with the exception of a few items. The willingness to use digital CBT, if trained, was the most highly endorsed item (95.0%). There was a general consensus on the importance of cultural adaptability and the incorporation of Islamic values and Pakistani family dynamics. The systemic barriers were shown to be significant, especially the lack of supervision (50.0% access), lack of organisational support (23.8% disagreed), and infrastructural issues like unreliable internet and electricity (77.5% acknowledged).

Conclusion: Results indicated that there is a high level of attitudinal readiness amongst the mental health professionals in Pakistan, but it will take targeted training, institutional support and culturally adapted digital platforms to be implemented.