Psychological Intervention by a Lay Person May Improve Depression and Anxiety in Adolescents

Source / Disclosures

Disclosures: Osborn and another author report support from the Templeton World Charity Foundation. Please see the study for relevant financial information from all other authors.


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According to the results of a randomized clinical trial in Kenya, a layman-delivered psychological intervention focusing on positive human attributes rather than psychopathology reduced depression and anxiety in adolescents.

“This intervention, Shamiri (Kiswahili to Thrive), is designed to be implemented with adolescents coming together in groups led by trained lay people,” Tom L. Osborn, Alberta, of the Shamiri Institute and the Department of Psychology at Harvard University, and his colleagues wrote in JAMA Psychiatry. “A preliminary proof-of-concept trial tested Shamiri with 51 young Kenyans (aged 14 to 17) who had high symptoms of anxiety and / or depression. Youth randomly assigned to Shamiri (n = 28) showed significantly greater reductions in symptoms of depression and anxiety than youth randomized to a control of study skills (n = 23).

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However, the small sample size and limited follow-up weakened this study, according to Osborn and colleagues. In the present study, they aimed to determine whether Shamiri, a 4-week layman-delivered intervention incorporating elements of the mindset of growth, gratitude, and affirmation of values, improved symptoms of depression and depression. anxiety in symptomatic Kenyan adolescents aged 13-18 years. They included outcomes assessed at baseline, after treatment, and a 2-week and 7-month follow-up in four secondary schools in two counties in Kenya and used intention-to-treat analyzes to analyze the effects.

Osborn and colleagues randomly assigned participants to the Shamiri intervention (n = 205) or to a study skill control group (n = 208), and those in both conditions gathered into groups with an average size of 9 participants for 60 minutes per week for 4 weeks. A total of 307 adolescents completed the 4-week intervention. The participants had an average age of 15.5 years and 65.21% were women. Symptoms of depression assessed through Item 8 of the Patient Health Questionnaire and symptoms of anxiety assessed through Item 7 of Generalized Anxiety Disorder were used as primary outcomes. The researchers hypothesized that analyzes of the imputed data reveal significant reductions in symptoms of depression and anxiety in participants assigned to Shamiri compared to those assigned to the study skill group.

The results showed that participants rated both Shamiri and study skills as very useful and that both reduced symptoms of depression and anxiety; however, according to analyzes with imputed data, those who received Shamiri had greater reductions in depressive symptoms after treatment, a 2-week follow-up and 7-month follow-up, as well as greater reductions in symptoms of depression. anxiety after treatment, 2 weeks follow-up and 7 months follow-up.

“Shamiri was created, and the study designed and implemented, by a multicultural team with a combined expertise in intervention science and culturally relevant context – an approach that may have value for global mental health research.” Osborn and colleagues wrote. “The positive results suggest the verifiable possibility that simple, inexpensive, designed interventions that focus on positive human attributes and character strengths and implemented by laypersons can usefully contribute to global mental health. “


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