Development of a transdiagnostic, low-intensity, psychological intervention for common adolescent mental health problems in Indian secondary schools. (July 2020)

• Record Type: Journal Article
• Authors: Michelson, Daniel; Malik, Kanika; Krishna, Madhuri; Sharma, Rhea; Mathur, Sonal; Bhat, Bhargav; Parikh, Rachana; Roy, Kallol; Joshi, Akankasha; Sahu, Rooplata; Chilhate, Bhagwant; Boustani, Maya; Cuijpers, Pim; Chorpita, Bruce; Fairburn, Christopher G.; Patel, Vikram
• Is Part Of: Behaviour research and therapy. Volume 130(2020)
• Publication Date: 2020-07
• Subjects: Adolescents -- Mental health -- Transdiagnostic -- Schools -- Psychological intervention -- India; PRIDE PremIum for aDolEscents; Cognitive therapy -- Periodicals; Psychotherapy -- Periodicals; 616.891
• DOI: 10.1016/j.brat.2019.103439
• Languages: English
• ISSNs: 0005-7967

Abstract

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. Highlights: PRIDE is developing a transdiagnostic, stepped care programme in Indian schools. Formative evidence supported problem solving as a first-line 'Step 1' intervention. The format was modified from guided self-help to an active therapy after piloting. The optimised intervention showed promising impact, acceptability and feasibility.