Psychological Treatments for the World: Lessons from Low- and Middle-Income Countries

Daisy R. Singla, Brandon A. Kohrt, Laura K. Murray, Arpita Anand, Bruce F. Chorpita, Vikram Patel

Research output: Contribution to journalArticle

Abstract

Common mental disorders, including depression, anxiety, and posttraumatic stress, are leading causes of disability worldwide. Treatment for these disorders is limited in low- and middle-income countries. This systematic review synthesizes the implementation processes and examines the effectiveness of psychological treatments for common mental disorders in adults delivered by nonspecialist providers in low- and middle-income countries. In total, 27 trials met the eligibility criteria; most treatments targeted depression or posttraumatic stress. Treatments were commonly delivered by community health workers or peers in primary care or community settings; they usually were delivered with fewer than 10 sessions over 2-3 months in an individual, face-to-face format. Treatments included common elements, such as nonspecific engagement and specific domains of behavioral, interpersonal, emotional, and cognitive elements. The pooled effect size was 0.49 (95% confidence interval = 0.36-0.62), favoring intervention conditions. Our review demonstrates that psychological treatments-comprising a parsimonious set of common elements and delivered by a low-cost, widely available human resource-have moderate to strong effects in reducing the burden of common mental disorders.

Original languageEnglish (US)
Pages (from-to)149-181
Number of pages33
JournalAnnual Review of Clinical Psychology
Volume13
DOIs
StatePublished - May 8 2017

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Keywords

  • Common elements
  • Global mental health
  • Implementation processes
  • Low- and middle-income countries
  • Meta-analysis
  • Psychological treatments
  • Systematic review

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

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