A guide to selecting psychological interventions that can be delivered by people who are not mental health specialists in low-resource settings

Abstract

Globally, most individuals with mental health conditions lack access to specialized care. One strategy to bridge this gap is training people who are not mental health professionals (non-specialists) to deliver brief, manualized psychological interventions, which have demonstrated effectiveness across diverse settings. However, selecting the most suitable intervention for specific populations, contexts, and psychological needs in low-resource settings can be challenging due to the growing number of possible interventions and the differences in evidence of benefits across them. To facilitate this decision-making process, we provide an overview of ten psychological interventions that have demonstrated effectiveness in randomized controlled trials when delivered by non-specialists in low-resource settings for adults: Cognitive Processing Therapy, Common Elements Treatment Approach, Counseling for Alcohol Problems, Friendship Bench, Group Interpersonal Therapy, Healthy Activity Program, Problem Management Plus, Self-Help Plus, Step-by-Step, and the Thinking Healthy Programme. The interventions vary in settings where they have demonstrated effectiveness and the evidence for which conditions show benefit (e.g., depression, posttraumatic stress, substance use, general psychological distress). Considerations when selecting interventions also include the duration of treatment, ranging from 4 to 16 sessions, and the duration of training required for nonspecialists, spanning from 5 to 12 days. This article, along with its visual summaries, serves as a guide to support selection of psychological interventions based on population needs, mental health conditions, and available resources.