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Cited by 322Mental Health Treatment and AccessPsychotherapy Techniques and ApplicationsHealth Policy Implementation Science

The DOI matches its Crossref record; 36 of the 37 references it cites were found in a registry or an index, and 1 are not checked yet.

Problem-solving therapy for depression and common mental disorders in Zimbabwe: piloting a task-shifting primary mental health care intervention in a population with a high prevalence of people living with HIV

Open access
Chibanda, Dixon, Mesu, Petra, Kajawu, Lazarus, Cowan, Frances, Araya, Ricardo, Abas, Melanie A·2011·BMC Public Health
DOI 10.1186/1471-2458-11-828PMC PMC3210104
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Abstract

BACKGROUND: There is limited evidence that interventions for depression and other common mental disorders (CMD) can be integrated sustainably into primary health care in Africa. We aimed to pilot a low-cost multi-component 'Friendship Bench Intervention' for CMD, locally adapted from problem-solving therapy and delivered by trained and supervised female lay workers to learn if was feasible and possibly effective as well as how best to implement it on a larger scale. METHOD: We trained lay workers for 8 days in screening and monitoring CMD and in delivering the intervention. Ten lay workers screened consecutive adult attenders who either were referred or self-referred to the Friendship Bench between July and December 2007. Those scoring above the validated cut-point of the Shona Symptom Questionnaire (SSQ) for CMD were potentially eligible. Exclusions were suicide risk or very severe depression. All others were offered 6 sessions of problem-solving therapy (PST) enhanced with a component of activity scheduling. Weekly nurse-led group supervision and monthly supervision from a mental health specialist were provided. Data on SSQ scores at 6 weeks after entering the study were collected by an independent research nurse. Lay workers completed a brief evaluation on their experiences of delivering the intervention. RESULTS: Of 395 potentially eligible, 33 (8%) were excluded due to high risk. Of the 362 left, 2% (7) declined and 10% (35) were lost to follow-up leaving an 88% response rate (n = 320). Over half (n = 166, 52%) had presented with an HIV-related problem. Mean SSQ score fell from 11.3 (sd 1.4) before treatment to 6.5 (sd 2.4) after 3-6 sessions. The drop in SSQ scores was proportional to the number of sessions attended. Nine of the ten lay workers rated themselves as very able to deliver the PST intervention. CONCLUSION: We have found preliminary evidence of a clinically meaningful improvement in CMD associated with locally adapted problem-solving therapy delivered by lay health workers through routine primary health care in an African setting. There is a need to test the effectiveness of this task-shifting mental health intervention in an appropriately powered randomised controlled trial. TRIAL REGISTRATION: ISRCTN: ISRCTN25476759.

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Figure 1 Some of the lay health workers involved in the Friendship Bench project, sitting in front of one of the Benches.
Figure 1 Some of the lay health workers involved in the Friendship Bench project, sitting in front of one of the Benches.CC BY · PubMed Central
Figure 2 Flow diagram of recruitment into the study.
Figure 2 Flow diagram of recruitment into the study.CC BY · PubMed Central

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Research works printed but not linked: 2

  1. Tibaijuka AK: Report of the Fact-Finding Mission to Zimbabwe to assess the Scope and Impact of Operation Murambatsvina by the UN Special Envoy on Human Settlements Issues In Zimbabwe. UN Habitat. 2005
  2. Amani Trust: The Chiweshe Nurse-Counsellor Programme: Trainer's Manual (revised). Harare. 1994

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Metadata

Authors
Chibanda, D., Mesu, P., Kajawu, L., Cowan, F., Araya, R., & Abas, M. A.
Affiliations
  • University of Zimbabwe (ZW)
  • Counselling Services Unit (ZW)
  • University of Bristol (GB)
  • King's College London (GB)
Corresponding author
Chibanda, Dixon
ORCID
Venue
BMC Public Health
Publisher
Springer Science and Business Media LLC
Published
2011-10-26
Volume
11
Issue
1
Pages
828-828
ISSN
1471-2458 (ISSN-L)
DOI
10.1186/1471-2458-11-828
PMC
PMC3210104
OpenAlex
W1969517414
Cited by
319
References
34
Citations by year
2026: 14 · 2025: 29 · 2024: 21 · 2023: 23 · 2022: 28 · 2021: 53 · 2020: 29 · 2019: 23 · 2018: 16 · 2017: 15 · 2016: 21 · 2015: 16 · 2014: 17 · 2013: 11 · 2012: 3
FWCI
13.49
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Public Health (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research Portal (King's College London) (acceptedVersion, cc-by)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • UCL Discovery (University College London) (submittedVersion)
  • Greater South Information System
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Keywords
problem-solving therapy, common mental disorders, depression, Friendship Bench, task shifting, lay health workers, primary care mental health, HIV, Zimbabwe, activity scheduling, feasibility
MeSH terms
Adult, Mental Disorders, Community Health Workers, Depression, Feasibility Studies, Female, Follow-Up Studies, Health Promotion, HIV, Humans, Male, Middle Aged, Personnel Staffing and Scheduling, Pilot Projects, Primary Health Care, Problem Solving, Surveys and Questionnaires, Zimbabwe, Program Evaluation, HIV Infections, Prevalence, Young Adult

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