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Table 1 Features of Friendship Bench Intervention

From: Problem-solving therapy for depression and common mental disorders in Zimbabwe: piloting a task-shifting primary mental health care intervention in a population with a high prevalence of people living with HIV

Theoretical basis Based on problem-solving therapy
Delivering agent Lay health workers (Health promoters). Mean age 58 sd 8.3, all female, mean years of education 8 sd 3.3, previous training in home based care for people living with HIV & AIDS, in community follow-up of persons on TB treatment and in delivering community health education and promotion e.g. through encouraging immunisation and methods to control disease outbreaks
Structure of intervention Six weekly sessions of 30-45 minutes delivered through the Friendship Bench over six weeks, including one or two home visits.
Structure of sessions and areas covered. Session 1. Problem identification: A) Share Shona Symptom Questionnaire (SSQ) information with client, explain symptoms in relation to kufungisisa, B) Actively listen to clients story, identify problems raised, clearly define problem/s. Problem exploration: C) understand the story, help client prioritise problems, D) brainstorm practical/feasible solutions, outline the options available, encourage client to think over solutions. Session 2. E. Home visit before next session/prayer with family. Session 3. F) Summarise session 1, prioritise problems then identify solution that is feasible, provide information on referral where necessary. Action plan: G) Zero in on a specific solution, focus on what client wants to do, H) How, when, what assistance is needed? Referral if necessary e.g. to income generating program. I). Identify activities the person used to find rewarding and which matter to them and encourage these Session 4. J) Brief review of session 3, Implementation: K) How will it be done? Motivate; homework, Refer if appropriate to agency or support group. Session 5) Home visit. Follow up: L) What has been achieved? What were/are the obstacles if any? Go back to session 3 and 4. Session 6: M) Reinforce sessions 3, 4 and 5. What has been achieved, repeat SSQ score. N) No improvement refer to nurse counsellor
Tools Multiple Symptoms Card seven step treatment plan, Referral manual
Training Two-week training before onset of Friendship Bench. Ongoing training every two weeks for the first six months; thereafter monthly.
Supervision Weekly one-hour group supervision by a general nurse with training in counselling. Group supervision from a clinical psychologist one hour every two weeks; group supervision by a psychiatrist every four weeks, 45 minutes.