Table 2. Comparison between the traditional CBT module and adapted Religion-cultural CBT .

	Traditional CBT	Adapted Religion-cultural CBT
Language	CBT manuals mostly in the English language	CBT manual in Bahasa Malaysia – the national language of Malaysia
Manual	CBT manual is designed by westerners using Western concepts that may not be compatible with the Malay culture	CBT Manual that is modified and adjusted according to the norms of Malaysian society, therefore, is culturally appropriate
Relaxation techniques	Traditional relaxation techniques – slow breathing techniques, progressive muscular relaxation Clients encouraged to practice twice a day and grade before and after	On top of the traditional relaxation techniques, Danny was asked to practice the slow breathing techniques after his Fajr and Isha’a prayers for 3-5 minutes. He was encouraged to pray five times a day regularly following the second Pillar of Islam. Prayer, a form of meditation, encourages a sense of being and promotes relaxation
Lifestyle modification	Lifestyle modification in the form of exercise, healthy eating	For Danny, he was encouraged to read verses of the Holy Quran and zikr (commemoration of Allah’s name) after his prayers, as part of enhancing his spirituality. He was advised to live a healthy lifestyle and live per his Islamic values – to follow the customs of Prophet Muhammad S.A.W (PBUH).
Gratitude exercises – gratitude is appreciating what is meaningful and valuable to self. it represents a state of being thankful and appreciating.	Clients are taught to be grateful for their life, situations, family etc.	Danny was taught to focus on the Islamic based on gratitude. He was encouraged to be grateful to God, people, and his surroundings through gratitude exercises. He was encouraged to refer to the Holy Quran and the work and experiences of the Prophet Muhammad (PBUH) in the Holy Quran who showed the highest level of gratitude to God despite unimaginable sufferings.
Invivo situational exposure	Clients choose the agoraphobic situations which they’ve avoided previously	Danny opted to perform this at a place close to his heart- the Mosque
Spirituality when discussing support system in CBT	Western CBT mentions spirituality without extra emphasis on it	Danny particularly mentioned religion and spirituality when talking about the support system. He considers himself a spiritual Muslim and believes in God.