Competency-based Training in Problem Management Plus: a Randomized Controlled Trial

Study Overview
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Brief Summary
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The proposed study in Nepal will evaluate if non-specialists participating in Equip-based Problem Management Plus training show greater competencies compared to non-specialists participating in standard Problem Management Plus training. The proposed study is a randomized controlled trial with mixed-methods components evaluating both quantitative outcomes and qualitative outcomes among non-specialists participating in the training and their trainers.

Detailed Description
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There is increasing recognition of the high burden of psychological distress among populations around the world. Increasingly, non-specialists (persons who do not have expertise in formal mental health training) are being used to deliver psychological services. There is a long history of successful implementation of psychological services by non-specialists in Nepal. Recently, a cluster randomized controlled trial of Problem Management Plus showed modest benefit over enhanced care as usual in southeastern Nepal. A recent initiative by the World Health Organization is being rolled out to improve the competencies of non-specialists participating in Problem Management Plus and similar trainings. This initiative is Ensuring Quality in Psychological Services (Equip). The proposed study in Nepal will evaluate if non-specialists participating in Equip-based Problem Management Plus training show greater competencies compared to non-specialists participating in standard Problem Management Plus training. The proposed study is a randomized controlled trial with mixed-methods components evaluating both quantitative outcomes and qualitative outcomes among non-specialists participating in the training and their trainers.

Official Title
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Comparing Strategies for Competency-based Training in Problem Management Plus to Improve Non-specialist Competencies for Responding to Psychological Distress: a Randomized Controlled Trial

Conditions
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Depression

Intervention / Treatment
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* Behavioral: Standard Problem Management Plus training (training as usual)
* Behavioral: Equip-based Problem Management Plus training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: No prior mental health professional training Literate in Nepali Exclusion Criteria: Any prior mental health professional training

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Persons without mental health professional experience will be randomized to either training as usual to develop Problem Management Plus competencies or they will be randomized to Problem Management Plus training that uses Equip principles of competency-based training.
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Training as usual<br>Standard Problem Management Plus training. | Behavioral: Standard Problem Management Plus training (training as usual)<br>* 10-day training on Problem Management Plus.<br>|
| Experimental: Equip-based training<br>Training that uses the Equip platform to assess competencies and incorporate this information into trainers and supervisors activities. | Behavioral: Equip-based Problem Management Plus training<br>* Training and supervision for Problem Management Plus in which the trainers and supervisors use the EQUIP platform for competency assessment and feedback.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Enhancing Assessment of Common Therapeutic Factors (unabbreviated title: Enhancing Assessment of Common Therapeutic Factors) | 15-item tool with 4 response levels, range is 15 to 60, with higher scores equating to more competency | Immediately after Problem Management Plus training (10-days post-baseline) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Enhancing Assessment of Common Therapeutic Factors (unabbreviated title: Enhancing Assessment of Common Therapeutic Factors) | 15-item tool with 4 response levels, range is 15 to 60, with higher scores equating to more competency | After Problem Management Plus supervision (approximately 45-days post-baseline) | 
| Problem Management Plus Competency Assessment (unabbreviated title: Problem Management Plus Competency Assessment) | 12-item tool with 4 response levels, range is 12 to 48, with higher scores equating to more competency | Immediately after Problem Management Plus training (10-days post-baseline) | 
| Problem Management Plus Competency Assessment (unabbreviated title: Problem Management Plus Competency Assessment) | 12-item tool with 4 response levels, range is 12 to 48, with higher scores equating to more competency | After Problem Management Plus supervision (approximately 45-days post-baseline) | 
| Group Facilitation Competency Assessment (unabbreviated title: Group Facilitation Competency Assessment) | 8-item tool with 4 response levels, range is 8 to 32, with higher scores equating to more competency | Immediately after Problem Management Plus training (10-days post-baseline) | 
| Group Facilitation Competency Assessment (unabbreviated title: Group Facilitation Competency Assessment) | 8-item tool with 4 response levels, range is 8 to 32, with higher scores equating to more competency | After Problem Management Plus supervision (approximately 45-days post-baseline) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Training, Competency, Psychological treatment