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Common factors in psychological treatments delivered by non-specialists in low- and middle-income countries: Manual review of competencies - 16/09/20

Doi : 10.1016/j.jbct.2020.06.001 
Gloria A. Pedersen a, , Pooja Lakshmin a, Alison Schafer b, Sarah Watts b, Kenneth Carswell b, Ann Willhoite c, d, Katherine Ottman a, Edith van’t Hof b, Brandon A. Kohrt a
a Division of Global Mental Health, Department of Psychiatry and Behavioral Sciences, George Washington University, 2120 L St NW, Suite 600, 20037 Washington DC, USA 
b World Health Organization, Department of Mental Health and Substance Use, Avenue Appia 20, 1211 Geneva 27, Switzerland 
c United States Agency for International Development, DCHA/DRG, Empowerment & Inclusion Division, Washington DC, USA 
d Child Protection in Emergencies, Child Protection, Programme Division, UNICEF Headquarters, 3 UN Plaza, 10017 New York, NY, USA 

Corresponding author.

Highlights

Fifteen common factors were identified across 16 manuals for psychological and psychosocial treatments delivered by non-specialists in low- and middle-income countries.
Common factors are present across all manuals for delivery of evidence-supported psychological and psychosocial interventions.
Manuals covered most common factors in detail, with 75% or more of manuals including description for 8 common factors: hope and expectancy for change, confidentiality, giving praise, psychoeducation, rapport building, empathy, incorporating coping mechanisms, and collaborative goal setting.
Harmonization of descriptions and concepts of common factors was possible across manuals.

Le texte complet de cet article est disponible en PDF.

Abstract

Delivery of psychological and psychosocial treatments by non-specialists in low-and middle-income countries (LMIC) is a growing strategy to address the global mental health treatment gap. However, little is known about which competencies are essential for non-specialists to effectively deliver treatment. Psychotherapy research in high-income countries suggests that effective treatment requires competency in common factors. Therefore, our objective was to identify how common factors are described in evidence-supported non-specialist interventions in LMICs. To meet this objective, we identified and coded common factors by reviewing 16 evidence-supported manuals for psychological treatments delivered by non-specialists in LMICs. World Health Organization (WHO) manuals and other non-proprietary manuals, with positive randomized control outcomes, were included in the review. Fifteen common factors were identified and described in most manuals: ‘promoting hope and realistic expectancy of change’ and ‘confidentiality’ were described in 15 manuals (94%), followed by ‘giving praise’ and ‘psychoeducation’ (88% of manuals), and ‘rapport building’ (81% of manuals). Descriptions of common factors were similar across manuals, suggesting that training and competency evaluation approaches can be harmonized across interventions. Compiling these descriptions from the manuals can inform foundational training in common factors for diverse cadres of non-specialists around the world.

Le texte complet de cet article est disponible en PDF.

Keywords : Competency, Common factors, Psychological and psychosocial treatment, Manualized intervention, Review, Non-specialist


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© 2020  Association Française de Therapie Comportementale et Cognitive. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 30 - N° 3

P. 165-186 - septembre 2020 Retour au numéro
Article précédent Article précédent
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