Health in Hand
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How it Works
Pocket Counselor is a mobile application that helps lay counselors deliver a culturally grounded mental health intervention to families with poor functioning and dynamics of distress. The app is designed to engage "natural counselors" - individuals who are already working with distressed families in their communities - and provide them with educational materials, structured therapy activities, and an interface to track the progress of their cases.
When a lay counselor sits down with a family, he or she can open Pocket Counselor and chose from a series of culturally adapted, evidence-based modules that will walk them through the process of delivering family therapy. The app will provide them with videos to use during the session, interactive activities, and resources for further referral.
The concept of Pocket Counselor is intentionally adaptable and applicable in a range of contexts and therefore is a scalable method to disseminate evidence-based treatments to the most underserved populations in low- and middle-income countries.
Take a virtual tour of Pocket Counselor by clicking on the phone
It is rare to find a family who has not been touched by a mental health disorder. Statistically, 1 in 4 people will be affected by a mental health disorder at some stage in life. Specifically, in a global survey of 17 countries, lifetime prevalence for any mental health disorder ranged from 12% to 47.7% (Kessler et al., 2009).
In developing countries, mental health services are extremely limited; approximately 75% of people affected by mental health issues do not have access to the care or treatments they need (WHO, 2011).
Consequently, in 2007 the Lancet Global Mental Health Group issued a call to action to scale up evidence-based mental health services in low-income countries, stating funding and research should be prioritized specifically to develop interventions that can be delivered by non-mental health professionals (Lancet Global Mental Health Group, 2007). This process of training non-mental health professionals is called “task-shifting.”
The process of disseminating evidence-based treatments by non-mental health professionals, or lay counselors, is fraught with challenges. Difficulties include training lay counselors, appropriately assessing patients, adhering to treatment protocols, and connecting counselors with supervisors and referral sources. To this end, we have designed a highly adaptable mobile technology application, Pocket Counselor, to bridge this clinical care gap and address these challenges. Pocket Counselor may be applied to any manualized mental health treatment independent of local resources; moreover, we have performed preliminary, proof-of-concept studies in a comparable, low-resource population with highly encouraging results.
Our Approach: Tuko Pamoja
Pocket Counselor was designed to complement Tuko Pamoja family interventions. Tuko Pamoja (“We are Together” in Kiswahili) is a components-based family intervention designed to decrease family conflict and improve family functioning in ways that will lead to improved caregiver and adolescent mental health and reduced adolescent risk behavior.
Tuko Pamoja includes modules (“somos” in Kiswahili) related to marriage, parent-adolescent relationships, family organization, adolescent mental health, caregiver mental health and adolescent risk behavior. Most modules follow a similar 10-step process that begins with examining aspects of the family system and progresses towards goal setting and planning and acting on solutions. Families only receive modules that they need based on their specific difficulties.
Implementation of Tuko Pamoja
Tuko Pamoja is implemented by community-based lay counselors. These individuals are community members who are already “natural counselors,” meaning that they are identified by the community as people who distressed families and adolescents already seek out for help. These counselors then receive training in Tuko Pamoja to equip them with additional skills to help these families.