Cited by 913Mental Health Treatment and AccessHealth Policy Implementation SciencePsychotherapy Techniques and Applications

The DOI matches its Crossref record; 107 of the 112 references it cites were found in a registry or an index, and 5 are not checked yet; none of the 22 sources its claims cite is checked for support yet.

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

Open access

Abstract

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.

Checked 2026-10-06 · 5 references not checked yet

Overview

Integrity signals

Registry

Crossref · 10.1146/annurev-clinpsy-032816-045217

Cites

107 of 112 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

57 Own result · 16 Not checked yet · 12 Own method · 8 Own interpretation · 4 No basis given

Verify all 22 references — free account

Show all 33 claims

  • Probably not a substantial claim. 32
  • It may state two separate claims as one. 46
64 of 64
  • The paper relies on this without support.

    There will never be enough mental health professionals to deliver psychological treatment in any country.

    “The rationale for the principle of involving NSPs is that it is extremely unlikely that there will ever be sufficient mental health professionals to deliver psychological treatment in any country; thus, dissemination hinges on delivery by NSPs.”
  • The paper relies on this without support.

    Psychological treatments rely on expensive but scarce mental health professionals for delivery.

    “Additionally, these psychological treatments rely on expensive but scarce mental health professionals for delivery.”
  • The paper relies on this without support.

    The vast majority of people with common mental disorders in low- and middle-income countries will seek treatment through primary health-care or other community platforms.

    “Moving to real-world, LMIC-based settings, in which the vast majority of individuals with CMDs will pursue treatment options through primary health-care or other community platforms, requires psychological treatments to be delivered by nonspecialist providers (NSPs; i.e., through task sharing) and addresses explanatory models distinct from those of mental health practitioners.”
  • The paper relies on this without support.

    The 27 included trials are representative of all psychological treatments delivered by nonspecialist providers in low- and middle-income countries.

    “We identified 27 trials that met our eligibility criteria, with 35 primary and secondary outcomes.”
  • The paper relies on this without support.

    The effect sizes from the included trials are not substantially biased by publication bias or selective reporting.

    “The SMD for the 24 primary outcomes was 0.49 (95% CI = 0.36–0.62), favoring the intervention with the inconsistency measure I2 = 83%”
  • The paper relies on this without support.

    The coding of treatment elements from trial descriptions accurately reflects the treatments as delivered.

    “We measured the internal consistency of the taxonomy by using Cronbach’s α”
  • The paper relies on this without support.

    The authors' self-reported treatment classes are accurate.

    “When asked, most authors (63%) indicated they used more than one class of treatments”
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Citations

Cites

Research works printed but not linked: 18

  1. Cochrane Collab. 2014. Review Manager 5 (RevMan 5): version 5.3.http://tech.cochrane.org/revman
  2. England MJ, 2015, Psychosocial Interventions for Mental and Substance Use Disorders: A Framework for Establishing Evidence-Based Standards
  3. Fritsch R, 2007, Rev. Med. Chil, 135, 587
  4. Gul A, 2004, J. Pak. Med. Assoc, 54, 549
  5. Hirani SS, 2010, South. Online J. Nurs. Res., 10, 6
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  9. PracticeWise., 2015, Psychosocial and combined treatments coding manual
  10. SAS Institute Inc., 2011, SAS/STAT 9.3
  11. van Ginneken N, 2013, Cochrane Database Syst. Rev., 19, CD009149
  12. van't Hof E, 2011, Afr. J. Psychiatry, 14, 200
  13. Verdeli H, 2003, World Psychiatry, 2, 114
  14. Weiss WM, 2016, Torture, 26, 17
  15. WHO (World Health Organ.)., 2014, Low-Intensity Psychological Interventions for People in Communities Affected by Adversity: A New Area of Mental Health and Psychosocial Work at WHO
  16. WHO (World Health Organ.)., 2014, Preventing Suicide: A Global Imperative
  17. WHO (World Health Organ.)., 2015, mhGAP Humanitarian Intervention Guide (mhGAP-HIG): Clinical Management of Mental, Neurological and Substance Use Conditions in Humanitarian Emergencies.
  18. World Bank Group., 2015, World Bank Country and Data Groups

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Metadata

Authors
Singla, D. R., Kohrt, B. A., Murray, L. K., Anand, A., Chorpita, B. F., & Patel, V.
Affiliations
  • University of Toronto (CA)
  • Duke University (US)
  • Johns Hopkins University (US)
  • Sangath (IN)
  • University of California, Los Angeles (US)
  • Harvard University (US)
Venue
Annual Review of Clinical Psychology
Published
2017-05-08
Volume
13
Issue
1
Pages
149-181
ISSN
  • 1548-5943 (ISSN-L)
  • 1548-5951
OpenAlex
W2404531844
Cited by
913
References
112
Citations by year
2026: 90 · 2025: 77 · 2024: 118 · 2023: 109 · 2022: 128 · 2021: 182 · 2020: 87 · 2019: 76 · 2018: 32 · 2017: 14
FWCI
9.00
Type
journal article
Language
en
Open access
Locations
  • Annual Review of Clinical Psychology (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • Wellcome Trust (106919, 106919/Z/15)
  • National Institute of Mental Health (K01MH104310, U19MH095687)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords
psychological intervention, common mental disorders, depression, anxiety, post-traumatic stress disorder, low- and middle-income countries, community health workers, peer-mediated intervention, primary care, brief intervention, treatment effectiveness, implementation process
MeSH terms
Mental Disorders, Developing Countries, Humans, Mental Health, Psychotherapy, Global Health

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