Browsing by Author "Kohrt BA"

Now showing 1 - 4 of 4

Competency-based training and supervision: development of the WHO-UNICEF Ensuring Quality in Psychosocial and Mental Health Care (EQUIP) initiative.
(2025-Jan) Kohrt BA; Pedersen GA; Schafer A; Carswell K; Rupp F; Jordans MJD; West E; Akellot J; Collins PY; Contreras C; Galea JT; Gebrekristos F; Mathai M; Metz K; Morina N; Mwenge MM; Steen F; Willhoite A; van Ommeren M; Underhill J; Socios En Salud, Lima, Perú; School of Social Work, University of South Florida, Tampa, FL, USA.; SystemSeed, Dover, DE, USA.; School of Social Work, University of South Florida, Tampa, FL, USA.; HealthRight, Kampala, Uganda; Vrjie University, Amsterdam, Netherlands.; University of Nairobi, Nairobi, Kenya.; Center for Global Mental Health Equity, The George Washington University, Washington, DC, USA.; Department of Mental Health, Brain Health, and Substance Use, WHO, Geneva, Switzerland.; Center for Global Mental Health Equity, The George Washington University, Washington, DC, USA. Electronic address: bkohrt@gwu.edu.; University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Research and Development Department, War Child Alliance, Amsterdam, Netherlands.; Mental Health and Psychosocial Support Team, Child Protection, UNICEF, New York, NY, USA.; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.; Amsterdam Institute of Social Science Research, University of Amsterdam, Amsterdam, Netherlands; Center for Global Mental Health, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK; Research and Development Department, War Child Alliance, Amsterdam, Netherlands.; Center for Victims of Torture, Tigray, Ethiopia.; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
Globally, there has not been a standardised approach to ensure that the growing number of people who are not licensed clinicians but are delivering psychological interventions and mental health services have the competencies to deliver those interventions and services safely. Therefore, WHO and UNICEF developed Ensuring Quality in Psychosocial and Mental Health Care (EQUIP). EQUIP is a free resource with a digital platform that can be used to guide competency assessment. We describe EQUIP's 5-year development (2018-23) and the rationale supporting its contents and use. Development phases included establishing consensus for competency-based strategies; selecting foundational competencies; evaluating feasibility of assessments, role plays, and technology; piloting EQUIP when training non-specialists; and public dissemination and ongoing adaptations to increase scalability. From the public launch in March, 2022, through to March, 2024, EQUIP's digital platform has been used in 794 training programmes in 36 countries with 3760 trainees resulting in 10 001 competency assessments.
Experiences and Perceptions of Telephone-delivery of the Common Elements Treatment Approach for Mental Health Needs Among Young People in Zambia During the COVID-19 Pandemic.
(2022) Munthali-Mulemba S; Figge CJ; Metz K; Kane JC; Skavenski S; Mwenge M; Kohrt BA; Pedersen GA; Sikazwe I; Murray LK; Department of Psychiatry, George Washington University School of Medicine and Health Sciences, Washington, DC, United States.; Centre for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia.; Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States.; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
BACKGROUND: Mental and behavioral health needs are immense in low-to-middle income countries (LMIC), particularly for adolescents and young adults (AYA). However, access to mental health services is limited in LMIC due to barriers such as distance to a health care site, low number of providers, and other structural and logistical challenges. During the COVID-19 pandemic, these barriers were significantly exacerbated and, thus, mental health services were severely disrupted. A potential solution to some of these barriers is remote delivery of such services via technology. Exploration of AYA experiences is needed to understand the benefits and challenges when shifting to remotely delivered services. METHODS: Participants included 16 AYA (15-29 years) residing in Lusaka, Zambia who met criteria for a mental or behavioral health concern and received telehealth delivery of the Common Elements Treatment Approach (CETA). AYA participated in semi-structured qualitative interviews to explore feasibility, acceptability, and barriers to telephone-delivered treatment in this context. Thematic coding analysis was conducted to identify key themes. FINDINGS: Three major response themes emerged: 1) Advantages of telehealth delivery of CETA, Disadvantages or barriers to telehealth delivery of CETA, 3) AYA recommendations for optimizing telehealth (ways to improve telehealth delivery in Zambia. Results indicate that logistical and sociocultural barriers i.e., providing AYA with phones to use for sessions, facilitating one face-to-face meeting with providers) need to be addressed for success of remotely delivered services. CONCLUSION: AYA in this sample reported telehealth delivery reduces some access barriers to engaging in mental health care provision in Zambia. Addressing logistical and sociocultural challenges identified in this study will optimize feasibility of telehealth delivery and will support the integration of virtual mental health services in the Zambian health system.
Global health reciprocal innovation to address mental health and well-being: strategies used and lessons learnt.
(2023-Nov) Turan JM; Vinikoor MJ; Su AY; Rangel-Gomez M; Sweetland A; Verhey R; Chibanda D; Paulino-Ramírez R; Best C; Masquillier C; van Olmen J; Gaist P; Kohrt BA; Research Department, Center for Infectious Disease Research in Zambia, Lusaka, Zambia.; Department of Medicine, The University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA.; Behavioral Science & Integrative Neuroscience Research Branch, Division of Neuroscience and Basic Behavioral Science, National Institute of Mental Health, Bethesda, Maryland, USA.; Sparkman Center for Global Health and Department of Health Policy and Organization, The University of Alabama at Birmingham School of Public Health, Birmingham, Alabama, USA jmturan@uab.edu.; Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.; Instituto de Medicina Tropical and Salud Global, Universidad Iberoamericana (UNIBE), Santo Domingo, Dominican Republic.; Center for Global Mental Health Equity, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.; Research Support Centre, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.; Friendship Bench Zimbabwe, Harare, Zimbabwe.; Office of AIDS Research, Division of Program Coordination, Planning, and Strategic Initiatives, Office of the Director, National Institutes of Health, Bethesda, Maryland, USA.; Faculty of Medicine and Health Sciences, Department of Family and Population and Health, University of Antwerp, Antwerp, Belgium.; Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
Over the past two decades there have been major advances in the development of interventions promoting mental health and well-being in low- and middle-income countries (LMIC), including delivery of care by non-specialist providers, incorporation of mobile technologies and development of multilevel community-based interventions. Growing inequities in mental health have led to calls to adopt similar strategies in high-income countries (HIC), learning from LMIC. To overcome shared challenges, it is crucial for projects implementing these strategies in different global settings to learn from one another. Our objective was to examine cases in which mental health and well-being interventions originating in or conceived for LMIC were implemented in the USA. The cases included delivery of psychological interventions by non-specialists, HIV-related stigma reduction programmes, substance use mitigation strategies and interventions to promote parenting skills and family functioning. We summarise commonly used strategies, barriers, benefits and lessons learnt for the transfer of these innovative practices among LMIC and HIC. Common strategies included intervention delivery by non-specialists and use of digital modalities to facilitate training and increase reach. Common barriers included lack of reimbursement mechanisms for care delivered by non-specialists and resistance from professional societies. Despite US investigators' involvement in most of the original research in LMIC, only a few cases directly involved LMIC researchers in US implementation. In order to achieve greater equity in global mental health and well-being, more efforts and targeted funding are needed to develop best practices for global health reciprocal innovation and iterative learning in HIC and LMIC.
Improving inter-rater reliability of the enhancing assessment of common therapeutic factors (ENACT) measure through training of raters.
(2022-Sep-07) Mwenge MM; Figge CJ; Metz K; Kane JC; Kohrt BA; Pedersen GA; Sikazwe I; Van Wyk SS; Mulemba SM; Murray LK; Columbia University Mailman School of Public Health, New York, USA.; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.; George Washington University School of Medicine, Washington, DC, USA, Washington, USA.; Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
BACKGROUND: As evidence supports task-shifting approaches to reduce the global mental health treatment gap, counselor competency evaluation measures are critical to ensure evidence-based therapies are administered with quality and fidelity. OBJECTIVE: This article describes a training technique for evaluating lay counselors' competency for mental health lay practitioners without rating scale experience. METHODS: Mental health practitioners were trained to give the Enhancing Assessment of Common Therapeutic Factors (ENACT) test to assess counselor proficiency in delivering the Common Elements Treatment Approach (CETA) in-person and over the phone using standardized video and audio recordings. A two-day in-person training was followed by a one-day remote training session. Training includes a review of item scales through didactic instructions, active learning by witnessing and scoring role-plays, peer interactions, and trainer observation and feedback. The trainees rated video and audio recordings, and ICC values were calculated. RESULTS: The training technique presented in this research helped achieve high counselor competency scores among lay providers with no prior experience using rating scales. ICC rated both trainings satisfactory to exceptional (ICC: .71 - .89). CONCLUSIONS: Raters with no past experience with rating scales can achieve high consistency when rating counselor competency through training. Effective rater training should include didactic learning, practical learning with trainer observation and feedback, and video and audio recordings to assess consistency.