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. 2020 Jul:130:103439.
doi: 10.1016/j.brat.2019.103439. Epub 2019 Jul 30.

Development of a transdiagnostic, low-intensity, psychological intervention for common adolescent mental health problems in Indian secondary schools

Daniel Michelson  1 , Kanika Malik  2 , Madhuri Krishna  2 , Rhea Sharma  2 , Sonal Mathur  2 , Bhargav Bhat  2 , Rachana Parikh  3 , Kallol Roy  4 , Akankasha Joshi  2 , Rooplata Sahu  2 , Bhagwant Chilhate  2 , Maya Boustani  5 , Pim Cuijpers  6 , Bruce Chorpita  7 , Christopher G Fairburn  8 , Vikram Patel  9
Affiliations

Development of a transdiagnostic, low-intensity, psychological intervention for common adolescent mental health problems in Indian secondary schools

Daniel Michelson et al. Behav Res Ther. 2020 Jul.

Abstract

Background: The PRIDE programme aims to establish a suite of transdiagnostic psychological interventions organised around a stepped care system in Indian secondary schools. This paper describes the development of a low-intensity, first-line component of the PRIDE model.

Method: Contextual and global evidence informed an intervention 'blueprint' with problem solving as the primary practice element. Successive iterations were tested and modified across two pilot cohort studies (N = 45; N = 39). Participants were aged 13-20 years and presenting with elevated mental health symptoms in New Delhi schools.

Results: The first iteration of the intervention, based on a guided self-help modality, showed promising outcomes and user satisfaction when delivered by psychologists. However, delivery was not feasible within the intended 6-week schedule, and participants struggled to use materials outside 'guidance' sessions. In Pilot 2, a modified counsellor-led problem-solving intervention was implemented by less experienced counsellors over a 3-4 week schedule. Outcomes were maintained, with indications of enhanced feasibility and acceptability. High demand was observed across both pilots, leading to more stringent eligibility criteria and a modified sensitisation plan.

Discussion: Findings have shaped a first-line intervention for common adolescent mental health problems in low-resource settings. A forthcoming randomised controlled trial will test its effectiveness.

Keywords: Adolescents; India; Mental health; Psychological intervention; Schools; Transdiagnostic.

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Figures

Fig. 1
Fig. 1
Schematic of intervention development process and outputs.
Fig. 2
Fig. 2
Case characteristics of pilot study participants.
See this image and copyright information in PMC

References

    1. Ali S., Rhodes L., Moreea O., McMillan D., Gilbody S., Leach C., Delgadillo J. How durable is the effect of low intensity CBT for depression and anxiety? Remission and relapse in a longitudinal cohort study. Behaviour Research and Therapy. 2017;94:1–8. - PubMed
    1. Barry M.M., Clarke A.M., Jenkins R., Patel V. A systematic review of the effectiveness of mental health promotion interventions for young people in low and middle income countries. BMC Public Health. 2013;13(1):835. - PMC - PubMed
    1. Belkin G.S., Unützer J., Kessler R.C., Verdeli H., Raviola G.J., Sachs K., Eustache E. Scaling up for the “bottom billion”:“5× 5” implementation of community mental health care in low-income regions. Psychiatric Services. 2011;62:1494–1502. - PubMed
    1. Bennett S.D., Cuijpers P., Ebert D.D., McKenzie Smith M., Coughtrey A.E., Heyman I. Practitioner review: Unguided and guided self‐help interventions for common mental health disorders in children and adolescents: A systematic review and meta‐analysis. Journal of Child Psychology and Psychiatry. 2019 (in press) - PubMed
    1. Bhola P., Sathyanarayanan V., Rekha D.P., Daniel S., Thomas T. Assessment of self-reported emotional and behavioral difficulties among pre-university college students in Bangalore, India. Indian Journal of Community Medicine: Official Publication of Indian Association of Preventive & Social Medicine. 2016;41(2):146. - PMC - PubMed

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