Problem Management Plus (PM+) in the treatment of common mental disorders in women affected by gender-based violence and urban adversity in Kenya; study protocol for a randomized controlled trial
Open accessAbstract
BACKGROUND: Women affected by adversity, including gender-based violence, are at increased risk for developing common mental disorders such as depression, anxiety and posttraumatic stress disorder (PTSD). The World Health Organization (WHO) has developed Problem Management Plus (PM+), a 5-session, individual psychological intervention program, that can be delivered by non-specialist counsellors that addresses common mental disorders in people affected by adversity. The objectives of this study are to evaluate effectiveness of PM+ among women who have been affected by adversity, including gender-based violence, and to perform a process evaluation. METHODS: Informed by community consultations, the PM+ manual has been translated and adapted to the local context. A randomized controlled trial will be carried out in the catchment areas of three local health care facilities in Dagoretti Sub County, Nairobi. After informed consent, females with high psychological distress (General Health Questionnaire-12 (score >2) and functional impairment (WHO Disability Assessment Schedule 2.0 score >16) will be randomised to PM+ (n = 247) or enhanced treatment as usual (n = 247). Post-treatment and 3-months post-treatment follow-up assessments include psychological distress, functional disability, PTSD symptoms, perceived problems for which the person seeks help, health care use and health costs. For evaluating the process of implementing PM+ within local communities in Nairobi 20 key informant interviews will be carried out in participants, PM+ providers, decision makers, clinical staff. DISCUSSION: If PM+ is proven effective, it will be rolled out to other low and middle income areas and other populations for further adaptation and testing. Trial registration Australian New Zealand Clinical Trials Registry, ACTRN12616000032459. Registered prospectively on January 18, 2016.
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Research in Kenya showed that PM+ was more effective in reducing mental health problems than enhanced usual care (EUC).
“Research in Kenya [26, 32] showed that PM+ was more effective in reducing mental health problems than enhanced usual care (EUC).”
From A brief transdiagnostic psychological intervention for Afghan asylum seekers and refugees in Austria: A randomized controlled trial (2020) · cites this paper as [32]
The Methods > Aim and design passage says the authors *will conduct* a Kenyan trial comparing PM+ with enhanced treatment as usual; it does not report a reduction in mental health problems. The Discussion likewise says “If proven effective,” contrary to the claim that this study showed PM+ was more effective. (LLM, conf=0.88)
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Experimental — accuracy not yet measuredThe secondary outcomes (PTSD symptoms and functional impairment) in the Kenya study also showed significant reductions but these effects were small relative to EUC.
“The secondary outcomes (PTSD symptoms and functional impairment) also showed significant reductions but these effects were small relative to EUC.”
From A brief transdiagnostic psychological intervention for Afghan asylum seekers and refugees in Austria: A randomized controlled trial (2020) · cites this paper as [32]
The Methods sections on Secondary outcomes and Primary outcomes describe planned measurements, and the Abstract > Methods says the Kenya trial will be carried out. Our copy reports no results establishing significant reductions or small effects relative to usual care. It also lists general functioning as a primary, not secondary, outcome. (LLM, conf=0.78)
Experimental — accuracy not yet measuredWomen who received PM+ reported significantly less psychological distress, with a moderate effect relative to EUC.
“Women who received PM+ reported significantly less psychological distress, with a moderate effect relative to EUC.”
From A brief transdiagnostic psychological intervention for Afghan asylum seekers and refugees in Austria: A randomized controlled trial (2020) · cites this paper as [32]
The Abstract > Methods and Methods > Primary outcomes describe a planned comparison of PM+ with enhanced treatment as usual and identify psychological distress as an outcome. The Discussion says effectiveness remains to be established; the copy reports no observed reduction, statistical significance, or moderate effect size (searched for the distress comparison and effect size). (LLM, conf=0.78)
Experimental — accuracy not yet measured
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- Authors
- Sijbrandij, M., Bryant, R. A., Schafer, A., Dawson, K. S., Anjuri, D., Ndogoni, L., Ulate, J., Hamdani, S. U., & van Ommeren, M.
- Affiliations
- Amsterdam Public Health (NL)
- UNSW Sydney (AU)
- World Vision International (GB)
- University of Liverpool (GB)
- Corresponding author
- Sijbrandij, Marit
- Venue
- International Journal of Mental Health Systems
- Published
- 2016-05-31
- Volume
- 10
- Issue
- 1
- Pages
- 44-44
- ISSN
- 1752-4458 (ISSN-L)
- PMC
- PMC4888633
- OpenAlex
- W2419417179
- Cited by
- 65
- References
- 27
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 15 · 2023: 7 · 2022: 3 · 2021: 4 · 2020: 11 · 2019: 6 · 2018: 8 · 2017: 2 · 2016: 2
- FWCI
- 9.42
- Type
- journal article
- Language
- en
- Update notices
- correction (2018-10-12)
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- International Journal of Mental Health Systems (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- VU Research Portal (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- Grand Challenges Canada (CA)
- World Vision Canada
- World Vision Australia
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Keywords
- Problem Management Plus, common mental disorders, gender-based violence, women, depression, anxiety, post-traumatic stress disorder, psychological distress, functional disability, brief psychological intervention, process evaluation, health care utilization, health care costs, Kenya
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