Psychological Treatments for the World: Lessons from Low- and Middle-Income Countries

By D. Singla, Brandon A. Kohrt, L. Murray, Arpita Anand, Bruce F. Chorpita, Vikram Patel. Annual Review of Clinical Psychology, 2017

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Common mental disorders, including depression, anxiety, and posttraumatic stress, are leading causes of disability worldwide. Treatment for these disorders is limited in low- and middle-income countries. This systematic review synthesizes the implementation processes and examines the effectiveness of psychological treatments for common mental disorders in adults delivered by nonspecialist providers in low- and middle-income countries. In total, 27 trials met the eligibility criteria; most treatments targeted depression or posttraumatic stress. Treatments were commonly delivered by community health workers or peers in primary care or community settings; they usually were delivered with fewer than 10 sessions over 2–3 months in an individual, face-to-face format. Treatments included common elements, such as nonspecific engagement and specific domains of behavioral, interpersonal, emotional, and cognitive elements. The pooled effect size was 0.49 (95% confidence interval = 0.36–0.62), favoring intervention conditions. Our review demonstrates that psychological treatments—comprising a parsimonious set of common elements and delivered by a low-cost, widely available human resource—have moderate to strong effects in reducing the burden of common mental disorders.

Subfields: Clinical Psychology, Public Health, Environmental and Occupational Health, Social Psychology

View Paper: https://www.semanticscholar.org/paper/b01e14915554334f9831f3c9b2efccae2432f5c8

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Citations in the corpus

Cultural Adaptation of Scalable Psychological Interventions: A New Conceptual Framework (2019, methodology): “…variance in symptoms and assumed causes, meta-analytic evi‐ dence suggests that evidence-based psychological interventions are effective for the treatment of common mental disorders among culturally diverse groups (Cuijpers, Karyotaki, Reijnders, Purgato, & Barbui, 2018; Singla et al., 2017).”
Mental health in elite athletes: International Olympic Committee consensus statement (2019) (2019, neutral): “A core challenge in developing this consensus statement was that the evidence comes predominantly from high income countries, which have more health services compared with low and middle income countries 41–43 where many athletes reside.”
The Lancet Commission on global mental health and sustainable development. (2018, background): “Second, effective treatment packages typically comprise a number of similar ‘elements’ spanning behavioural, interpersonal, cognitive and emotional domains.(76) This is consistent with a recent demonstration, involving 832 treatments tested in 437 randomized clinical trials for child and adolescent ”
Poverty, depression, and anxiety: Causal evidence and mechanisms (2020, background): “Evidence from multiple countries shows that “psychosocial” treatments such as manualized talk therapies can be highly effective at low cost, even when delivered by nonspecialist community health workers (122, 123).”