New stress management course for people living with adversity

Self-Help Plus is a stress management course intended for groups of up to 30 people who have lived through or are living through adversity, whether due to personal difficulties, work- or family-related stress or issues that affect whole communities such as armed conflict, violence, disease and poverty.

Self-Help Plus can be used in all setting including areas where mental health and psychosocial support needs are great, but the services providing such support are either stretched or non-existent.

The course package, which consists of an innovative format of pre-recorded audio and an illustrated guide ̶ Doing What Matters in Times of Stress ̶ can be delivered by non-specialist facilitators following a short training. This delivery method greatly increases the opportunities for use by large numbers of people.

Based on Acceptance and Commitment Therapy (ACT) – a form of cognitive behavioural therapy – the course has already been tested in three randomized controlled trials: with female refugees from South Sudan living in a settlement in Uganda, with refugees from different nationalities in multiple European countries and with Syrian refugees in Turkey. These trials showed that the intervention was effective in reducing psychological distress in adults with moderate to severe psychological distress and in preventing the onset of mental disorders in distressed populations affected by adversity. Other outcomes included reductions in symptoms of common mental disorders such as depression and post-traumatic stress and also improvements in general health, functioning and well-being.

Self-Help Plus was tested with groups of different sizes meeting in person, but it could potentially be adapted and tested for delivery in other formats such as videoconferencing or podcast or radio programmes. Such delivery mechanisms would be particularly useful in contexts where public health or logistical constraints make it difficult for participants to meet in person.

This new training course complements other WHO psychological interventions that can be delivered by non-specialists such as Problem Management Plus, Group Problem Management Plus and Thinking Healthy.

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