Competency-based Training in Problem Management Plus: a Randomized Controlled Trial (EQUIP-PM+)

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

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.

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.

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.

The persons without mental health professional training who are randomized to either training as usual or Equip-based training will not be informed about how the two training arms differ. Outcome assessors will not be told if the trainees are in training as usual or Equip-based training.

Training that uses the Equip platform to assess competencies and incorporate this information into trainers and supervisors activities.

Training and supervision for Problem Management Plus in which the trainers and supervisors use the EQUIP platform for competency assessment and feedback.

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

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

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

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

Group Facilitation Competency Assessment (unabbreviated title: Group Facilitation Competency Assessment)

Group Facilitation Competency Assessment (unabbreviated title: Group Facilitation Competency Assessment)

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