Epping-Jordan, J., Harris, R., Brown,F.L., Carswell, K., Foley, C., García-Moreno, C., Kogan, C., & van Ommeren, M. (2016). Self-Help Plus (SH+): a new WHO stress management package. World Psychiatry, 15, 295-296.

Consistent with its recommendations for stress management interventions1, the World Health Organization (WHO) has developed a new psychological intervention for managing stress and coping with adversity. This new intervention is intended to be relevant for coping with any type of adversity, including chronic poverty, endemic community and gender-based violence, long-term armed conflict, and displacement. It is especially targeted towards places with enormous needs but limited humanitarian access, such as Syria and South Sudan.

Following exposure to adversity, rates of diverse mental health problems and non-pathological distress increase. At the same time, most people affected by adversity do not have access to effective mental health and psychosocial support2. Without mental health specialists on the ground, either for direct service delivery or for training and supervising non-specialists3, 4, new approaches need to be established that can be delivered without an extensive workforce for mental health.

SH+ was developed to address these needs. It does not require much time from experts for implementation: instead, it uses a guided self-help format and is delivered through a pre-recorded audio course, complemented with bibliotherapy. The potential of using a course to access hard-to-reach populations has been demonstrated previously5. Evidence for bibliotherapy is also promising6. Furthermore, research has found that guided self-help programs produce better results than “pure” (unguided) self-help, and the effects produced by guided self-help are surprisingly similar to face-to-face psychological treatment7. SH+ was designed to be relevant for large segments of adversity-affected populations: it is intended to be transdiagnostic, easily adaptable to different cultures and languages, and both meaningful and safe for people with and without mental disorders. The program was developed with experts in psychological care and global mental health, and colleagues in the humanitarian field. It underwent extensive peer-review, with 43 external experts reviewing the intervention.