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The Journal of Behavioral Health Services & Research

Open Access 12-12-2023

Implementing a Non-Specialist Delivered Psychological Intervention for Young Adolescents in a Protracted Refugee Setting: a Qualitative Process Evaluation in Lebanon

Authors: Rayane Ali, MBA, Felicity L. Brown, PhD, MPsychClin, Kerrie Stevenson, MBChB BMedSci FHEA MSc MFPH, Mark Jordans, PhD, MSc, Karine Taha, MSc, Mounif El Amine, BA Psych, Frederik Steen, MSc, Bassel Meksassi, BA, Joseph Elias, BA, May Aoun, MSc, Bayard Roberts, PhD, MSc, Marit Sijbrandij, PhD, Pim Cuijpers, PhD, Aemal Akhtar, PhD, Aiysha Malik, DPhil, DCLinPsych, Aniek Woodward, MSc, Daniela C. Fuhr, DrPH, on behalf of the STRENGTHS Consortium

Published in: The Journal of Behavioral Health Services & Research

Abstract

There has been an increase in the evaluation and implementation of non-specialist delivered psychological interventions to address unmet mental health needs in humanitarian emergencies. While randomized controlled trials (RCTs) provide important evidence about intervention impact, complementary qualitative process evaluations are essential to understand key implementation processes and inform future scaling up of the intervention. This study was conducted as part of an RCT of the Early Adolescents Skills for Emotions (EASE) psychological intervention for young adolescents with elevated psychological distress (predominantly with a Syrian refugee background) in Lebanon. Our aims were firstly to conduct a qualitative process evaluation to understand stakeholder experiences and perceived impact of the intervention and identify barriers and facilitators for implementation, and secondly to explore considerations for scaling up. Eleven key informant interviews and seven focus groups were conducted with 39 respondents including adolescent and caregiver participants, trainers, providers, outreach workers, and local stakeholders. Data were analyzed using inductive and deductive thematic analysis. Respondents perceived the intervention to be highly needed and reported improvements in adolescent mental health and wellbeing. Key implementation factors that have potential to influence engagement, adherence, and perceived impact included the socio-economic situation of families, mental health stigma, coordination within and between sectors (particularly for scaling up), embedding the intervention within existing service pathways, having clear quality and accountability processes including training and supervision for non-specialists, and sustainable funding. Our findings provide important context for understanding effectiveness outcomes of the RCT and highlights factors that need to be considered when implementing a mental health intervention on a larger scale in a complex crisis.

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Title: Implementing a Non-Specialist Delivered Psychological Intervention for Young Adolescents in a Protracted Refugee Setting: a Qualitative Process Evaluation in Lebanon
Authors: Rayane Ali, MBA
Felicity L. Brown, PhD, MPsychClin
Kerrie Stevenson, MBChB BMedSci FHEA MSc MFPH
Mark Jordans, PhD, MSc
Karine Taha, MSc
Mounif El Amine, BA Psych
Frederik Steen, MSc
Bassel Meksassi, BA
Joseph Elias, BA
May Aoun, MSc
Bayard Roberts, PhD, MSc
Marit Sijbrandij, PhD
Pim Cuijpers, PhD
Aemal Akhtar, PhD
Aiysha Malik, DPhil, DCLinPsych
Aniek Woodward, MSc
Daniela C. Fuhr, DrPH
on behalf of the STRENGTHS Consortium
Publication date: 12-12-2023
Publisher: Springer US
Published in: The Journal of Behavioral Health Services & Research
Print ISSN: 1094-3412
Electronic ISSN: 2168-6793
DOI: https://doi.org/10.1007/s11414-023-09870-3

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Implementing a Non-Specialist Delivered Psychological Intervention for Young Adolescents in a Protracted Refugee Setting: a Qualitative Process Evaluation in Lebanon

Abstract

Keynote webinar | Spotlight on medication adherence

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Abstract

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