Problem Management Plus (PM+)

Problem Management Plus (PM+) is a brief 5-session trans-diagnostic psychological WHO intervention with strategies that could be delivered by non-specialist lay-providers to adults in distress. Two randomized controlled trials in Pakistan and Kenya demonstrated the efficacy of individually delivered PM+. In order to make PM+ more salable and acceptable in different contexts, PM+ was adapted through this project to deliver to groups in Nepal.

In Nepal, the study was divided into four phases:

• Study phase 1 was the manual adaptation to the local context;
• Study phase 2 was an exploratory single-blind cluster randomized controlled trial (RCT) in Sindhuli;
• Study phase 3 was a qualitative process evaluation of phase 2;
• Study phase 4 was a single-blind cluster RCT in flood-affected Morang district;
• Study phase 5 was a qualitative process evaluation of phase 4.

After the intervention was proven effective, WHO planned to release PM+ for global use.

Objectives: To adapt the Group PM+ manual for use by lay Community Psychosocial Workers in Nepal; to evaluate the feasibility and acceptability of the locally adapted version; and to test the effectiveness of the locally adapted version of Group PM+ in Nepal.

Target group: Adults with emotional and practical problems

Implementation district: Sindhuli District for pilot trial and Morang district for the definitive trial

Time frame: September 2016 – August 2019

Supported by: World Health Organization (WHO)

Partners: George Washington University, Duke University

Publications:

1. Feasibility of Group Problem Management Plus (PM+) to improve mental health and functioning of adults in earthquake-affected communities in Nepal
2. Effectiveness of Group Problem Management Plus (Group-PM+) for adults affected by humanitarian crises in Nepal: study protocol for a cluster randomized controlled trial
3. Protocol for a feasibility study of group-based focused psychosocial support to improve the psychosocial well-being and functioning of adults affected by humanitarian crises in Nepal: Group Problem Management Plus (PM+)

Conference Presentation:

1. Cultural Adaptation of Group Problem Management Plus (PM+) in Nepal