Community Based Psychological Intervention For Persons Living With Disabilities
Condition: Physical Condition, Minor Psychological Component; Psychological Distress
Study type: Interventional

Summary: 
      Mental health problems are increasing in Pakistan and there is a 90% treatment gap in mental
      health services. Accessibility towards mental health services is limited due to range of
      factors including low income and resources, lack of the trained staff and lack of specialized
      and non-specialized mental health facilities. Therefore, there is a dire need to develop
      indigenous solution of the mental health issues grounded in Islamic teaching.

      In this regard this study is designed to address the mental health issues at community level.
      Therefore, this study divided into two phases. In first phase the aim of the study is to
      adapt World Health Organization recommended psychological intervention for paraprofessionals
      and to train the paraprofessional on this indigenously adapted intervention. Subsequently, in
      second phase the study aims to assess the effectiveness of the indigenously adapted Problem
      Management Plus (IA-PM+) as an evidence based remedy in the treatment of psychological
      distress of person living with disabilities (PWDs).
    

Detailed description: 
      Prevalence of disability is higher in Low and middle income countries (LMICs). Persons living
      with disabilities are more vulnerable to develop psychopathology due to their low level of
      functioning, their complex and speciﬁc needs. Consequently, Persons living with disabilities
      (PWDs) are expected to experience more adverse psychological ailments as compared to the
      persons living without disabilities particularly in the rural parts of the countries.
      Accessibility towards mental health services in Pakistan has been limited due to range of
      factors including low income and resources, lack of the trained staff and lack of specialized
      and non-specialized mental health facilities. These challenges are required to be dealt at
      locally at micro and macro levels systemically and effectively. This requires development and
      innovation in the existing infrastructure by devising multidisciplinary community based
      treatment policy in building mental health care services. Therefore, to integrate the mental
      health care services at primary care level, there is a dire need to develop indigenous
      psychological interventions in a simplified form so that people can quickly learn their
      utilization not only from the health professionals but also from the para-professionals as
      well.

      Due to the lack of specialized mental health services and human resources in low resource
      settings, task shifting is a well-known strategy, designed by World Health Organization to
      bridge the treatment gap in mental health problems. This strategy empowers the health
      workers, such as nurses and non-specialist to perform specific roles to bridge the available
      treatment gap. In addition to this, deliverance of evidence based psychological treatment by
      para-professionals/ non-specialists will not only help in reducing the financial and human
      resources but also might be able to reduce the stigma associated with mental illness.

      Realizing the influence of religion on the general population, the American Psychological
      Association (APA) has recommended to view the religion as a significant aspect of human life
      and as such psychologists need to get special knowledge and training on religious
      psychotherapy.

      In this regard this study is designed to address the mental health issues at community level.
      Therefore, this study divided into two phases. In first phase the aim of the study is to
      adapt World Health Organization recommended psychological intervention for paraprofessionals
      and to train the paraprofessional on this indigenously adapted intervention. Subsequently, in
      second phase the study aims to assess the effectiveness of the indigenously adapted Problem
      Management Plus (IA-PM+) as an evidence based remedy in the treatment of psychological
      distress of person living with disabilities (PWDs).
    

Intervention name(s): Indigenously adapted problem management plus (IA-PM+)
Intervention type(s): Behavioral
Intervention description(s): The IA-PM+ manual would be comprised of the following evidence-based techniques: (a) problem solving, (b) stress management, (c) behavioral activation and (d) accessing social support. The IA-PM+ intervention consisting of five sessions, will teach the participants techniques to manage their emotional problems.
Other intervention name(s): Problem management plus (PM+)
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Research design of the study shall consists of two-arms, single-blind cluster randomized controlled trial (c-RCT). While Randomized Control Trial (RCT) shall consists of two groups: Active Treatment (AT) and Delayed Treatment Control (DTC).
Masking: Triple (Participant, Care Provider, Outcomes Assessor)
Primary purpose: Treatment