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.

Journal: International journal of mental health systems

Volume: 10

Issue: 

Year of Publication: 2016

Affiliated Institutions:  Department of Clinical, Neuro- and Developmental Psychology, VU University Amsterdam and EMGO Institute for Health and Care Research, Van der Boechorststraat , BT Amsterdam, The Netherlands. School of Psychology, University of New South Wales, Sydney, Australia. World Vision International and World Vision Australia, Burwood East, Australia. World Vision Kenya, Nairobi, Kenya. World Vision Canada, Mississauga, Canada. University of Liverpool, Liverpool, UK ; Human Development Research Foundation, Islamabad, Pakistan. Department of Mental Health and Substance Abuse, World Health Organization (WHO), Geneva, Switzerland.

Abstract summary 

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.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.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.

Authors & Co-authors:  Sijbrandij Bryant Schafer Dawson Anjuri Ndogoni Ulate Hamdani van Ommeren

Study Outcome 

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Statistics
Citations :  World Health Organization . Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence. Geneva: World Health Organization and London School of Hygiene and Tropical Medicine; 2013.
Authors :  9
Identifiers
Doi : 44
SSN : 1752-4458
Study Population
Women,Females
Mesh Terms
Other Terms
Anxiety;Cognitive behavioural therapy;Common mental disorders;Depression;Gender-based violence;Intimate partner violence;Low- and middle income countries;Non-specialist counsellors;Posttraumatic stress disorder;Task-shifting;Trauma
Study Design
Study Approach
Country of Study
Kenya
Publication Country
England