A Field Report on the Pilot Implementation of Problem Management Plus with Lay Providers in an Eritrean Refugee Setting in Ethiopia

We conducted a pilot to train paraprofessional helpers to deliver Problem Management Plus (PM+) in refugee camps with Eritrean refugees in Ethiopia. This field report presents reflections from trainers, supervisors and participants. We offer lessons learned from material translation and adaptation, including strategies for training on PM+ with low-literacy populations. The training covered foundational helping skills and the PM+ intervention. We share lessons from the training process, highlighting the importance of role plays and considerations for trainee selection.

We discuss the importance of supervision for this intervention, particularly in contexts where paraprofessionals have experienced violence and displacement. We present challenges encountered, as well as adaptations for a low-resource, camp-based context. Overall we found it was possible to train nonspecialist helpers in PM+ within 2 weeks; however, intensive supervision was required for the first course of clients. We found PM+ to be useful, but our field experience suggests that PM+ may be more appropriately applied with the local population facing adversity, as we found it did not meet some of the primary needs, constraints and symptom severity encountered in the refugee camp context. Further field experience and research is needed to understand in which contexts PM+ is suitable for widespread roll-out