scholarly journals Theory of change for complex mental health interventions: 10 lessons from the programme for improving mental healthcare

2018 ◽  
Vol 5 ◽  
Author(s):  
Erica Breuer ◽  
Mary De Silva ◽  
Crick Lund
Author(s):  
Abhijit Nadkarni ◽  
Mary J. De Silva ◽  
Vikram Patel

Most mental health interventions are complex as they are made up of a number of interconnected components, acting both independently and interdependently. This inherent complexity makes the development and evaluation of such interventions a complex process. Following a structured approach to the development and evaluation of complex interventions helps ensure that the process is systematic, rigorous, and replicable. In this chapter we demonstrate how systematically conducted formative research, consistent with the MRC framework, will ensure that due consideration is given to the sociocultural and health systems context. We use the case study of an ongoing complex intervention development and evaluation program in India (PREMIUM) to illustrate the application of the development and feasibility/piloting phases of the MRC framework. We describe two complementary frameworks, the Normalization Process Theory and the Theory of Change that can be used to strengthen the MRC framework for the development of mental health interventions.


Author(s):  
Alina Ionescu ◽  
Tom Van Daele ◽  
Albert Rizzo ◽  
Carolyn Blair ◽  
Paul Best

AbstractVirtual reality is increasingly recognized as a powerful method for clinical interventions in the mental health field, but has yet to achieve mainstream adoption in routine mental healthcare settings. A similar, yet slightly different technology, immersive 360° videos might have the potential to cover this gap, by requiring both lower costs and less technical skills to construct and operate such virtual environments. This systematic review therefore aims to identify, evaluate, and summarize mental health interventions using immersive 360° videos to support an understanding of their implementation in daily clinical practice. The quality of the 14 selected studies was evaluated using a critical appraisal tool, addressing populations with clinical levels of psychopathological symptoms, somatic conditions associated with psychological implications, and other at-risk groups. Immersive 360° videos successfully increased users’ feelings of presence, given their realistic features, and therefore yielded positive outcomes in clinical interventions where presence is considered as an essential precondition. Because the technical skills required to create immersive 360° video footage are fairly limited, most of the interventions using this approach have been created by mental health researchers or clinicians themselves. Immersive 360° videos are still in an early phase of implementation as a tool for clinical interventions for mental health, resulting in high heterogeneity in focus, procedures, and research designs. An important next step for making use of this technology may therefore involve the creation of standardized procedures, as a means to increase the quality of research and evidence-based interventions.


Author(s):  
Maya Fennig

Abstract As the number of refugees worldwide reaches unprecedented levels, social workers’ ability to provide effective and appropriate mental healthcare to this population is as critical as ever. This article provides a review of contemporary debates revolving around the cultural adaptation (CA) of mental health interventions—when it is warranted, what approach should be taken and what components of an intervention should be adapted. CA is presented as a promising and pragmatic approach to service delivery, one that can assist clinical social workers in designing and implementing interventions that reflect refugees’ local needs and knowledge without neglecting important advances in research evidence and clinical expertise. However, it is not without its challenges. By drawing on literature related to the integration of cultural and contextual factors in mental health interventions and services, the article addresses critical issues in the CA approach and asks: is it possible to strike a balance between fidelity to evidence-based interventions and culturally compatible care?


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