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The Healthy Activity Program lay counsellor delivered treatment for severe depression in India: systematic development and randomised evaluation

Background Reducing the global treatment gap for mental disorders requires treatments that are economical, effective and culturally appropriate. Aims To describe a systematic approach to the development of a brief psychological treatment for patients with severe depression delivered by lay counsello...

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Autores principales: Chowdhary, Neerja, Anand, Arpita, Dimidjian, Sona, Shinde, Sachin, Weobong, Benedict, Balaji, Madhumitha, Hollon, Steven D., Rahman, Atif, Wilson, G. Terence, Verdeli, Helena, Araya, Ricardo, King, Michael, Jordans, Mark J. D., Fairburn, Christopher, Kirkwood, Betty, Patel, Vikram
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Royal College of Psychiatrists 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4816974/
https://www.ncbi.nlm.nih.gov/pubmed/26494875
http://dx.doi.org/10.1192/bjp.bp.114.161075
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author Chowdhary, Neerja
Anand, Arpita
Dimidjian, Sona
Shinde, Sachin
Weobong, Benedict
Balaji, Madhumitha
Hollon, Steven D.
Rahman, Atif
Wilson, G. Terence
Verdeli, Helena
Araya, Ricardo
King, Michael
Jordans, Mark J. D.
Fairburn, Christopher
Kirkwood, Betty
Patel, Vikram
author_facet Chowdhary, Neerja
Anand, Arpita
Dimidjian, Sona
Shinde, Sachin
Weobong, Benedict
Balaji, Madhumitha
Hollon, Steven D.
Rahman, Atif
Wilson, G. Terence
Verdeli, Helena
Araya, Ricardo
King, Michael
Jordans, Mark J. D.
Fairburn, Christopher
Kirkwood, Betty
Patel, Vikram
author_sort Chowdhary, Neerja
collection PubMed
description Background Reducing the global treatment gap for mental disorders requires treatments that are economical, effective and culturally appropriate. Aims To describe a systematic approach to the development of a brief psychological treatment for patients with severe depression delivered by lay counsellors in primary healthcare. Method The treatment was developed in three stages using a variety of methods: (a) identifying potential strategies; (b) developing a theoretical framework; and (c) evaluating the acceptability, feasibility and effectiveness of the psychological treatment. Results The Healthy Activity Program (HAP) is delivered over 6–8 sessions and consists of behavioral activation as the core psychological framework with added emphasis on strategies such as problem-solving and activation of social networks. Key elements to improve acceptability and feasibility are also included. In an intention-to-treat analysis of a pilot randomised controlled trial (55 participants), the prevalence of depression (Beck Depression Inventory II ⩾19) after 2 months was lower in the HAP than the control arm (adjusted risk ratio = 0.55, 95% CI 0.32–0.94, P = 0.01). Conclusions Our systematic approach to the development of psychological treatments could be extended to other mental disorders. HAP is an acceptable and effective brief psychological treatment for severe depression delivered by lay counsellors in primary care.
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spelling pubmed-48169742016-05-09 The Healthy Activity Program lay counsellor delivered treatment for severe depression in India: systematic development and randomised evaluation Chowdhary, Neerja Anand, Arpita Dimidjian, Sona Shinde, Sachin Weobong, Benedict Balaji, Madhumitha Hollon, Steven D. Rahman, Atif Wilson, G. Terence Verdeli, Helena Araya, Ricardo King, Michael Jordans, Mark J. D. Fairburn, Christopher Kirkwood, Betty Patel, Vikram Br J Psychiatry Papers Background Reducing the global treatment gap for mental disorders requires treatments that are economical, effective and culturally appropriate. Aims To describe a systematic approach to the development of a brief psychological treatment for patients with severe depression delivered by lay counsellors in primary healthcare. Method The treatment was developed in three stages using a variety of methods: (a) identifying potential strategies; (b) developing a theoretical framework; and (c) evaluating the acceptability, feasibility and effectiveness of the psychological treatment. Results The Healthy Activity Program (HAP) is delivered over 6–8 sessions and consists of behavioral activation as the core psychological framework with added emphasis on strategies such as problem-solving and activation of social networks. Key elements to improve acceptability and feasibility are also included. In an intention-to-treat analysis of a pilot randomised controlled trial (55 participants), the prevalence of depression (Beck Depression Inventory II ⩾19) after 2 months was lower in the HAP than the control arm (adjusted risk ratio = 0.55, 95% CI 0.32–0.94, P = 0.01). Conclusions Our systematic approach to the development of psychological treatments could be extended to other mental disorders. HAP is an acceptable and effective brief psychological treatment for severe depression delivered by lay counsellors in primary care. Royal College of Psychiatrists 2016-04 /pmc/articles/PMC4816974/ /pubmed/26494875 http://dx.doi.org/10.1192/bjp.bp.114.161075 Text en © The Royal College of Psychiatrists 2015. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY) licence.
spellingShingle Papers
Chowdhary, Neerja
Anand, Arpita
Dimidjian, Sona
Shinde, Sachin
Weobong, Benedict
Balaji, Madhumitha
Hollon, Steven D.
Rahman, Atif
Wilson, G. Terence
Verdeli, Helena
Araya, Ricardo
King, Michael
Jordans, Mark J. D.
Fairburn, Christopher
Kirkwood, Betty
Patel, Vikram
The Healthy Activity Program lay counsellor delivered treatment for severe depression in India: systematic development and randomised evaluation
title The Healthy Activity Program lay counsellor delivered treatment for severe depression in India: systematic development and randomised evaluation
title_full The Healthy Activity Program lay counsellor delivered treatment for severe depression in India: systematic development and randomised evaluation
title_fullStr The Healthy Activity Program lay counsellor delivered treatment for severe depression in India: systematic development and randomised evaluation
title_full_unstemmed The Healthy Activity Program lay counsellor delivered treatment for severe depression in India: systematic development and randomised evaluation
title_short The Healthy Activity Program lay counsellor delivered treatment for severe depression in India: systematic development and randomised evaluation
title_sort healthy activity program lay counsellor delivered treatment for severe depression in india: systematic development and randomised evaluation
topic Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4816974/
https://www.ncbi.nlm.nih.gov/pubmed/26494875
http://dx.doi.org/10.1192/bjp.bp.114.161075
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