Tol, W. A., Augustinavicius, J., Carswell, K. Adaku, A. M., Leku, R., Brown, F. L., Garcia-Moreno, C., Ventevogel, P., White, R. G., Kogan, C.S., Bryant, R. and van Ommeren, M. (2018).

Implementing evidence-based psychological interventions in low-resource refugee settings is challenging, because of the need for an extensive workforce of trainers, supervisors and facilitators1, 2. Self-Help Plus (SH+) was developed by the World Health Organization (WHO) as a tool potentially applicable in those settings3.

SH+ is a guided self-help intervention consisting of five audio-recorded sessions and an illustrated self-help manual3. It can be provided to large groups (20 to 30 participants) and facilitated by lay helpers with minimal training. It aims to reduce psychological distress in people with a range of common mental disorders and subthreshold symptoms. It is based on acceptance and commitment therapy, a third wave cognitive behavioral therapy focused on enhancing psychological flexibility4.

We adapted SH+ for South Sudanese refugees and conducted a feasibility cluster randomized controlled trial of the intervention in Rhino Camp, a refugee settlement area in northern Uganda5. Our focus in this study was on women, since prior intervention adaptation and piloting had shown the need for separate evaluation efforts with men and women. We randomly allocated one village to SH+ and one to enhanced usual care. Within each village, we randomly selected households and screened one Juba Arabic-speaking consenting woman (age ≥18 years) until 25 eligible women were identified per village.