posted on 2023-06-09, 18:26authored byDaniel Michelson, Kanika Malik, Madhuri Krishna, Rhea Sharma, Sonal Mathur, Bhargav Bhat, Rachana Parikh, Kallol Roy, Akankasha Joshi, Rooplata Sahu, Bhagwant Chilhate, Maya Boustani, Pim Cuijpers, Bruce Chorpita, Christopher G Fairburn, Vikram Patel
Background: The PRIDE programme aims to establish a suite of transdiagnostic psychological interventions organised around a stepped care system in Indian secondary schools. This paper describes the development of a low-intensity, first-line component of the PRIDE model. Method: Contextual and global evidence informed an intervention ‘blueprint’ with problem solving as the primary practice element. Successive iterations were tested and modified across two pilot cohort studies (N=45; N=39). Participants were aged 13–20 years and presenting with elevated mental health symptoms in New Delhi schools. Results: The first iteration of the intervention, based on a guided self-help modality, showed promising outcomes and user satisfaction when delivered by psychologists. However, delivery was not feasible within the intended 6-week schedule, and participants struggled to use materials outside ‘guidance’ sessions. In Pilot 2, a modified counsellor-led problem-solving intervention was implemented by less experienced counsellors over a 3–4 week schedule. Outcomes were maintained, with indications of enhanced feasibility and acceptability. High demand was observed across both pilots, leading to more stringent eligibility criteria and a modified sensitisation plan. Discussion: Findings have shaped a first-line intervention for common adolescent mental health problems in low-resource settings. A forthcoming randomised controlled trial will test its effectiveness.