Planning the scale up of brief psychological interventions using theory of change

Background
A large mental health treatment gap exists among conflict-affected populations, and Syrian refugees specifically. Promising brief psychological interventions for conflict-affected populations exist such as the World Health Organization’s Problem Management Plus (PM+) and the Early Adolescent Skills for Emotions (EASE) intervention, however, there is limited practical guidance for countries of how these interventions can be taken to scale. The aim of this study was to unpack pathways for scaling up PM+ and EASE for Syrian refugees.

 

Methods
We conducted three separate Theory of Change (ToC) workshops in Turkey, the Netherlands, and Lebanon in which PM+ and EASE are implemented for Syrian refugees. ToC is a participatory planning process involving key stakeholders, and aims to understand a process of change by mapping out intermediate and long-term outcomes on a causal pathway. 15–24 stakeholders were invited per country, and they participated in a one-day interactive ToC workshop on scaling up.

 

Results
A cross-country ToC map for scale up brief psychological interventions was developed which was based on three country-specific ToC maps. Two distinct causal pathways for scale up were identified (a policy and financing pathway, and a health services pathway) which are interdependent on each other. A list of key assumptions and interventions which may hamper or facilitate the scaling up process were established.

 

Conclusion
ToC is a useful tool to help unpack the complexity of scaling up. Our approach highlights that scaling up brief psychological interventions for refugees builds on structural changes and reforms in policy and in health systems. Both horizontal and vertical scale up approaches are required to achieve sustainability. This paper provides the first theory-driven map of causal pathways to help support the scaling-up of evidence-based brief psychological interventions for refugees and populations in global mental health more broadly.



Geachte bezoeker,

De informatie die u nu opvraagt, kan door psychotraumanet niet aan u worden getoond. Dit kan verschillende redenen hebben, waarvan (bescherming van het) auteursrecht de meeste voorkomende is. Wanneer het mogelijk is om u door te verwijzen naar de bron van deze informatie, dan ziet u hier onder een link naar die plek.

Als er geen link staat, kunt u contact opnemen met de bibliotheek, die u verder op weg kan helpen.

Met vriendelijke groet,
Het psychotraumanet-team.


Reference: 
Daniela C. Fuhr, Ceren Acarturk, Marit Sijbrandij, Felicity L. Brown, Mark J. D. Jordans, Aniek Woodward, Michael McGrath, Egbert Sondorp, Peter Ventevogel, Zeynep Ikkursun, Rabih El Chammay, Pim Cuijpers & Bayard Roberts | 2020
In: BMC Health Services Research : ISSN: 1472-6963 | 20 | august | 801
https://doi.org/10.1186/s12913-020-05677-6
Open Access
Keywords: 
Affected Populations, Education, Interventions, Mental health care, Methodology, Prevention, Refugees, Syrians, Treatment, War