Developing knowledge-based psychotherapeutic competencies in non-specialist providers: a pre-post study with a nested randomised controlled trial of a coach-supported versus self-guided digital training course for a problem-solving psychological intervention in India

We evaluated a digital learning programme for non-specialists to develop knowledge-based competencies in a problem-solving intervention for adolescents to examine the overall impact of training on knowledge-based competencies among learners; and to compare the effects of two training conditions (self-guided digital training with or without coaching) in a nested parallel, two-arm, individually randomised controlled trial. Eligible participants were 18 or older; fluent in Hindi or English; able to access digital training; and had no prior experience of delivering structured psychotherapies. 277 participants were enrolled from 31 March 2022 to 19 June 2022 of which 230 (83%) completed the study. There was a significant increase in competency score from pre-training (Mean = 7.01, SD = 3.29) to post-training (Mean = 8.88, SD = 3.80), 6 weeks after the pre-training assessment. Knowledge competency scores showed larger increase among participants randomised to the coaching arm (AMD = 1.09, 95% CI 0.26-1.92, p = 0.01) with an effect size (d) of 0.33 (95% CI 0.08-0.58). More participants completed training in the coaching arm (n = 96, 69.6%) compared to the self-guided training arm (n = 56, 40.3%). In conclusion, a coach-supported remote digital training intervention is associated with enhanced participation by learners and increased psychotherapeutic knowledge competencies.</p

Coach-supported versus self-guided digital training course for a problem-solving psychological intervention for nonspecialists: protocol for a pre-post nested randomized controlled trial

Background: Psychosocial interventions delivered by non-specialists can be effective at reducing common adolescent mental health problems in low-resource settings. However, there is a lack of evidence on resource-efficient methods for building capacity to deliver these interventions. Objective: This study will evaluate the effects of a digital training course, delivered in a self-guided format or with coaching, on non-specialists’ competency to deliver a problem-solving intervention intended for adolescents with common mental health problems in India. Methods: We will conduct a pre-post study with a nested parallel, two-arm, individually randomised controlled trial. The study aims to recruit 262 participants, randomised 1:1 to receive either a self-guided digital training course or a digital training course with weekly individualised coaching provided remotely by telephone. In both arms, the digital training will be accessed over 4-6 weeks. Participants will be non-specialists (i.e., without prior practice-based training in psychological therapies) recruited from among university students and affiliates of non-governmental organisations in Delhi and Mumbai, India. Results: Outcomes will be assessed at baseline and six weeks post-randomisation using a knowledge-based competency measure that incorporates a multiple-choice quiz format. The primary hypothesis is that the digital training course (irrespective of coaching) improves knowledge-based competency scores. The secondary hypothesis is that provision of coaching alongside the digital training course will have an incremental effect on competency scores. Conclusions: The study will address an evidence gap on the effectiveness of training methods for non-specialist providers of adolescent mental health interventions in low-resource settings. The findings will be used to support wider efforts to scale up evidence-based mental health interventions for young people Clinical Trial: The study was registered on 11th March 2022 at www. clinicaltrials.gov, NCT05290142