TY - JOUR
T1 - Outcomes of an individual counselling programme in Grozny, Chechnya
T2 - A randomised controlled study
AU - Lenglet, Annick
AU - Lopes-Cardozo, Barbara
AU - Shanks, Leslie
AU - Blanton, Curtis
AU - Feo, Concetta
AU - Tsatsaeva, Zalina
AU - Idrisov, Kyuri
AU - Bolton, Paul A.
AU - Pintaldi, Giovanni
N1 - Funding Information:
We would like to extend our thanks to all the counsellors of the MSF Mental Health Programme in Grozny for their continued dedication and support to the population of Chechnya in confronting and alleviating mental health problems. We would like to thank the Directors of Hospital 7, Hospital 9 and the Regional Hospital in Grozny for allowing this study to take place in these locations. We would like to thank Marise Denault for critical review of the manuscript. Clare Griffith provided editorial assistance to this manuscript. Finally, we would like to thank all study participants for their contribution to this study. All research was carried out by MSF staff as part of their roles.
Publisher Copyright:
© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2018/8/1
Y1 - 2018/8/1
N2 - Objectives To evaluate the effectiveness of individual counselling on functioning of clients participating in a mental health intervention in a humanitarian setting. Design Randomised controlled trial. Setting Mental health programme implemented by Médecins Sans Frontières in Grozny, Republic of Chechnya. Participants 168 eligible clients were randomly assigned to the intervention and waitlisted (2 months) arms between November 2014 and February 2015. Intervention Individual counselling sessions. Main outcome measures Change in functioning was measured using the Short Form 6 (SF6) and gender-specific locally adapted Chechen functioning instruments in the intervention group at the end of counselling and the waitlisted group after their waitlisted period. Unadjusted differences in gain scores (DGSs) between intervention and waitlisted groups were calculated with effect size (Cohen's d) for both tools. Linear regression compared the mean DGS in both groups. Results The intervention group (n=78) improved compared with waitlisted controls (n=80) on the SF6 measures with moderate to large effect sizes: general health (DGS 12.14, d=0.52), body pain (DGS 10.26, d=0.35), social support (DGS 16.07, d=0.69) and emotional functioning (DGS 16.87, d=0.91). Similar improvement was seen using the Chechen functioning instrument score (female DGS '0.33, d=0.55; male DGS '0.40, d=0.99). Adjusted analysis showed significant improvement (p<0.05) in the intervention group for all SF6 measures and for the Chechen functioning instrument score in women but not men (p=0.07). Conclusions Individual counselling significantly improved participants' ability to function in the intervention group compared with the waitlisted group. Further research is needed to determine whether similar positive results can be shown in other settings and further exploring the impact in male clients' population. Trial registration number NTR4689.
AB - Objectives To evaluate the effectiveness of individual counselling on functioning of clients participating in a mental health intervention in a humanitarian setting. Design Randomised controlled trial. Setting Mental health programme implemented by Médecins Sans Frontières in Grozny, Republic of Chechnya. Participants 168 eligible clients were randomly assigned to the intervention and waitlisted (2 months) arms between November 2014 and February 2015. Intervention Individual counselling sessions. Main outcome measures Change in functioning was measured using the Short Form 6 (SF6) and gender-specific locally adapted Chechen functioning instruments in the intervention group at the end of counselling and the waitlisted group after their waitlisted period. Unadjusted differences in gain scores (DGSs) between intervention and waitlisted groups were calculated with effect size (Cohen's d) for both tools. Linear regression compared the mean DGS in both groups. Results The intervention group (n=78) improved compared with waitlisted controls (n=80) on the SF6 measures with moderate to large effect sizes: general health (DGS 12.14, d=0.52), body pain (DGS 10.26, d=0.35), social support (DGS 16.07, d=0.69) and emotional functioning (DGS 16.87, d=0.91). Similar improvement was seen using the Chechen functioning instrument score (female DGS '0.33, d=0.55; male DGS '0.40, d=0.99). Adjusted analysis showed significant improvement (p<0.05) in the intervention group for all SF6 measures and for the Chechen functioning instrument score in women but not men (p=0.07). Conclusions Individual counselling significantly improved participants' ability to function in the intervention group compared with the waitlisted group. Further research is needed to determine whether similar positive results can be shown in other settings and further exploring the impact in male clients' population. Trial registration number NTR4689.
KW - Chechnya
KW - anxiety and depression
KW - functioning
KW - individual counselling
KW - mental health
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U2 - 10.1136/bmjopen-2017-019794
DO - 10.1136/bmjopen-2017-019794
M3 - Article
C2 - 30139892
AN - SCOPUS:85053107056
SN - 2044-6055
VL - 8
JO - BMJ open
JF - BMJ open
IS - 8
M1 - e019794
ER -