Clinical Trial Summary
There is lack of feasible and effective curricula that can rapidly be taught on basic mental
health and psychosocial helping skills. Through the World Health Organization Ensuring
Quality in Psychological Support initiative, a curriculum has been developed focusing on
common factors in mental health and psychosocial support, such as verbal and nonverbal
communication skills, empathy, rapport building, and promoting hope and expectancy of change.
To minimize training burden and maximize effectiveness, this has been designed as a
competency-based training wherein target competencies are evaluated throughout the training
so that it can tailored to trainees preexisting skills, rather than using a one-size-fits-all
approach to the training. The training duration and content is modular and flexible, with
approximately 16 hours of modules content. The investigator's goal is to conduct a
mixed-methods evaluation of the foundational helping skills program. In three countries,
Nepal, Peru, and Uganda, two trainers (total n=6 across countries) and 36 service providers
(total n=108 across countries) without prior training in mental health and psychosocial
support skills will receive the training. Their competency in foundational helping skills
will be evaluated prior to training using an objective structured clinical examination
approach with standardized role plays using trained raters and actor (i.e., standardized
clients). Role play ratings will be made using the ENhancing Assessment of Common Therapeutic
factors. In addition, trainees knowledge and perceived self-efficacy in foundational helping
skills will be evaluated pre- and post-training. Trainers and trainees will also participate
in qualitative interviews regarding feasibility, acceptability, and perceived benefit of the
foundational helping skills program. A mixed methods evaluation of the foundational helping
skills curriculum will help to inform further revision of the materials on the Ensuring
Quality in Psychological Support platform. Determination of the change in skills, knowledge,
and self-efficacy will identify effective components of the platform and areas for further
refinement. Ultimately, an effective training program in foundational helping skills will
contribute to improved health, psychological, and social services around the world.
The World Health Organization Ensuring Quality in Psychological Support program is currently
developing a Universal Foundational Helping Skills Training package. This training package
will be freely available for use by all health professionals and other service providers
seeking to develop basic skills in mental health and psychosocial support. These foundational
helping skills are based upon common factors in the mental health and psychological services,
which have been widely researched and identified as essential and universal prerequisites for
the effective delivery of any psychosocial or psychological components in health
interventions. These are also foundational skills are also part of the competencies for
non-specialists to deliver psychological interventions in global mental health. Competent use
of these skills by providers improves outcomes for people accessing all fields of health
services--ranging from surgery to pain clinics--support greater treatment adherence. A
foundational helping skills training curriculum is needed to promote competency in the
provision of warm and trusting relationships between health care providers and people
accessing health services. Other foundational helping skills include rapport building, the
demonstration of empathy, using culturally or age-appropriate terminology and concepts for
distress, and ensuring communication of hope. This training guidance will fill the gap many
training programs for providers who are not mental health specialists, and the training
guidance will be feasible for implementation in low-resource settings. The training will be
aligned with the World Health Organization competency framework for the health sector that is
under development, which stipulates foundational helping skills as essential for all health
cadres. The World Health Organization Universal Foundational Helping Skills Training package
has the potential to improve competency for basic mental health and psychosocial support
services delivered by any health cadres. This training package, alongside other quality
improvement activities, will lead to more effective delivery of quality care for clients and
will be one step closer to achieving the global communities' and World Health Organization's
goal of universal health care. The goal of this study is to conduct a mixed-methods
evaluation of the Foundational Helping Skills curriculum by observing outcomes for trainees
in the program who not have prior mental health and psychosocial support skills training.