Peer-delivered Cognitive Behavioural Therapy (CBT)

Background: Following the 2014 Ebola virus disease (EVD) outbreak in West Africa, the UK Department for International Development funded South London and Maudsley National Health Service (NHS) to develop a psychological intervention that ex-Ebola Treatment Centre (ETC) staff could be trained to deliver to their peers to improve mental health in Sierra Leone.

Aim: The two key aims were to assess the feasibility of training a national team to deliver a cognitive behavioural therapy (CBT)-based group intervention, and to evaluate the effectiveness of the overall intervention within this population.

Methods: UK clinicians travelled to Sierra Leone to train a small team of ex-ETC staff in a three-phased CBT-based intervention. Standardised clinical measures, as well as bespoke measures, were applied with participants through the intervention to assess changes in mental health symptomology, and the effectiveness of the intervention.

Results: The results found improvements across all factors of mental health in the bespoke measure from phase 1 to phase 3. Additionally, the majority of standardised clinical measures showed improvements between phase 2 and the start of phase 3, and pre- and post-phase 3.

Conclusion: Overall, the findings suggest that it is possible to train staff from ETCs to deliver effective CBT interventions to peers. The implications of these results are discussed, including suggestions for future research and clinical intervention implementation within this population. The limitations of this research are also addressed.

Rank: 86

First Author: Waterman

Outcome: Stress,Depression,Anxiety,Anger,Well-being,Somatization,PTSD,Psychosocial Functioning,Social Support,Sleep/Exhaustion,Drinking Behaviors

Outcome p-value: Stress:⭑⭑, Depression:⭑⭑, Anxiety:⭑, Anger:⭑⭑, Well-being:⭑⭑, Somatization:⭑⭑, PTSD:⭑⭑, Psychosocial Functioning:⭑⭑, Social Support:⭑, Sleep/Exhaustion:⭑⭑, Drinking Behaviors:⭑

Intervention Category: Peer Support,Coping Skills Development

Time per Employee (hours): 18

Hours per Employee: 18

D&B Study Quality Rating: 13

Reviewer Confidence: 2

Country: Sierra Leone

Study Design Type: Quasi-experimental

Materials Available to Implement: Intervention described in manuscript. Corresponding author: samantha.waterman@nhs.net is no longer at that address.

Organiz./Individ. Focus: Individual

Prevention Category: Secondary,Tertiary

Effect size Small:

Effect size Medium:

Reference: Waterman, S., Hunter, E. C. M., Cole, C. L., Evans, L. J., Greenberg, N., Rubin, G. J., & Beck, A. (2018). Training peers to treat Ebola centre workers with anxiety and depression in Sierra Leone. International Journal of Social Psychiatry, 64(2), 156–165. https://doi.org/10.1177/0020764017752021