Mental Health Nurses' Perspectives on Cognitive Behavioural Therapy for Individuals Diagnosed with Schizophrenia in Saudi Arabia: A Qualitative Study.

BACKGROUND/OBJECTIVES: Cognitive behavioural therapy (CBT) is an effective intervention for promoting personal recovery among individuals diagnosed with schizophrenia; however, Saudi Arabia has a shortage of healthcare professionals trained to deliver it. Mental health nurses are well positioned to help address this gap. This study explored mental health nurses' perspectives on a proposed culturally adapted CBT intervention for individuals diagnosed with schizophrenia and identified perceived barriers and facilitators to its implementation. METHODS: Situated within the development phase of the Medical Research Council framework for complex interventions, the study examined perceived acceptability and anticipated feasibility rather than efficacy. Three face-to-face focus groups involving 19 mental health nurses were conducted between December 2020 and February 2021 at a tertiary mental health hospital in Riyadh, Saudi Arabia, during the COVID-19 pandemic. The focus group questions were informed by a systematic review of culturally adapted CBT components, and data were analysed using framework analysis. RESULTS: Three themes emerged: acceptability, with nurses recognising the value of CBT in promoting recovery; barriers, including lack of role clarity within mental health nursing policy, dominance of the medical model, and engagement difficulties among individuals diagnosed with schizophrenia; and facilitators, including supportive nursing management, training opportunities, and family involvement. CONCLUSIONS: Mental health nurses expressed support for delivering CBT but identified organisational and training-related barriers. Successful implementation will require clear policy frameworks, structured culturally adapted CBT training, ongoing clinical supervision, supportive nursing management, and collaborative approaches that appropriately involve families.