health: beneficiaries of the combined treatment arm (IPT-G+) were 10 pp less likely to have minimal depression compared with those who received IPT-G alone at the 12-month followup. These negative effects were still present and statistically significant at the 24-month follow-up. There were no impacts on human capital outcomes. We hypothesize that the negative impact of cash reflects the fact that it was distributed right before the onset of the COVID-19 pandemic – an unexpected negative shock. Exploratory analysis of data from the follow-up surveys suggests that the adolescent beneficiaries were frustrated by their inability to put the cash towards their own goals (such as starting a small enterprise), since they had to divert part or all of the transfer towards the essential needs of their families. We discuss this finding in more detail in Section 3.4.

Our study contributes to a growing literature on the impact of CBP/IPT interventions on mental health in LMICs. Lay-provider led therapies have received considerable interest, and were shown to be effective (in the short run) by Singla et al. (2017), who conducted a meta-analysis of 27 studies with a highly significant average effect size of 0.4 standard deviations. However, a number of more recent studies have produced longer-term results and the findings are mixed. Baranov et al. (2020) showed sustained effects of the Thinking Healthy Program (THP), which is a CBT-like intensive intervention adopted by the WHO, on depression among women with perinatal depression in Pakistan after 7 years - with lasting effects on financial empowerment and investments in children, particularly among mothers who gave birth to daughters. In contrast, Bhat et al. (2022) and Maselko et al. (2020) evaluate peer-delivered programs based on THP to women suffering from maternal depression in South Asia and find no impacts on depression or other outcomes 3 to 4 years post-intervention.<sup>4</sup> In another notable contribution, Blattman et al. (2023) evaluate a groupbased CBT intervention targeted to young men actively involved in crime and violence in Liberia’s capital Monrovia and found that therapy reduced antisocial behaviors 10 years later.

In line with our findings, the above evidence suggests that CBT-based therapy interventions can be effective in improving psychological well-being in the short-term. However, these effects often do not persist in the longer-term and therapy alone rarely causes persistent effects on economic outcomes, such as consumption expenditures, assets, or employment.<sup>5</sup>

> 4Bhat et al. (2022) also report on the Health Activity Programme (HAP), a psychological treatment based on behavioral activation targeted to adults in primary health centers in Goa, India. They find that, unlike THP, HAP caused sustained reductions in depression 5 years post-intervention and improved their self-belief, reduced their overconfidence, and increased self-assessed levels of patience and altruism. However, it had no effects on employment or consumption, suggesting the possibility of other constraints to improvements for those outcomes.

> 5A recent meta-analysis of RCTs of mental health interventions in LMICs generally supports this conclusion, although it does find some effects on time in and functioning at work (Lund et al., 2022).

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