Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
BMC Psychiatry. 2011 Sep 30;11:156. doi: 10.1186/1471-244X-11-156.
The majority of South Africans with a DSM-IV diagnosis receive no treatment for their mental health problems. There is a move to simplify treatment for common mental disorders (CMDs) in order to ease access. Brief problem solving therapy (PST) might fill the treatment gap for CMD's in deprived communities in South Africa. This pilot study evaluates the feasibility, acceptability and effectiveness of this PST program for CMD's in deprived communities around Cape Town.
A Dutch problem solving program was adapted and translated into English, Xhosa and Afrikaans and thereafter implemented in townships around Cape Town. An initial attempt to recruit participants for online PST proved difficult, and so the program was adapted to a booklet format. Volunteers experiencing psychological distress were invited to participate in the either individually or group delivered 5-week during self-help program. To evaluate the effectiveness, psychological distress was administered through self-report questionnaires. After completion of the intervention participants also rated the program on various acceptability aspects.
Of 103 participants, 73 completed 5 weeks of brief PST in a booklet/workshop format. There were significantly more dropouts in those who used the booklet individually than in the group. Psychological distress measured on the K-10 and SRQ fell significantly and the program was evaluated positively.
The results suggest that brief problem solving in a booklet/workshop format may be an effective, feasible and acceptable short-term treatment for people with CMD's in deprived communities. In this setting, group delivery of PST had lower drop-out rates than individual delivery, and was more feasible and acceptable. Randomized controlled trials are needed to evaluate the effect of brief self-help PST more rigorously.
大多数南非人被 DSM-IV 诊断为患有精神健康问题，但他们中大多数人并未接受任何治疗。为了方便获取治疗，南非正在简化对常见精神障碍（CMD）的治疗。简短问题解决治疗（PST）可能会填补南非贫困社区常见精神障碍治疗的空白。本试点研究评估了这种针对贫困社区 CMD 的 PST 方案的可行性、可接受性和有效性。
对荷兰的问题解决方案进行了改编和翻译，形成英文、科萨语和南非荷兰语版本，随后在开普敦周围的城镇实施。最初尝试招募在线 PST 参与者很困难，因此该方案被改编为手册形式。邀请经历心理困扰的志愿者参加为期 5 周的自我帮助计划，可单独或小组形式参与。为了评估有效性，通过自我报告问卷评估心理困扰。干预完成后，参与者还对方案的各个可接受性方面进行了评价。
在 103 名参与者中，有 73 名以手册/工作坊形式完成了 5 周的简短 PST。单独使用手册的参与者中，辍学人数明显多于小组参与者。K-10 和 SRQ 上的心理困扰显著下降，方案得到了积极评价。
结果表明，以手册/工作坊形式进行简短的问题解决可能是一种有效、可行和可接受的针对贫困社区 CMD 患者的短期治疗方法。在这种环境下，PST 的小组提供比个体提供的辍学率更低，并且更可行和更可接受。需要进行随机对照试验更严格地评估简短自助 PST 的效果。
