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Annual Review of Clinical Psychology

Volume 13, 2017

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

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.

Keyword(s): common elements, global mental health, implementation processes, low- and middle-income countries, meta-analysis, psychological treatments, systematic review
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2017-05-08
2024-04-16
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Psychological Treatments for the World: Lessons from Low- and Middle-Income Countries
Annual Review of Clinical Psychology 13, 149 (2017); https://doi.org/10.1146/annurev-clinpsy-032816-045217
/content/journals/10.1146/annurev-clinpsy-032816-045217
/content/journals/10.1146/annurev-clinpsy-032816-045217
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