Publications by authors named "Gloria Pedersen"

Introduction: Contextually responsive implementation support strategies are needed to enhance the integration of mental health services into primary health care. Technical assistance is widely used as a core "capacity building" strategy, primarily for increasing the motivation and capacity of individuals (e.g.

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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.

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Background: The use of feedback to address gaps and reinforce skills is a key component of successful competency-based mental health and psychosocial support intervention training approaches. Competency-based feedback during training and supervision for personnel delivering psychological interventions is vital for safe and effective care.

Aims: For non-specialists trained in low-resource settings, there is a lack of standardised feedback systems.

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Background: Given the protective effect of nurturing caregivers and families for child and adolescent mental health, there is a need to review and synthesize research evidence regarding the effectiveness of parenting and family interventions in low and middle-income countries, including humanitarian settings. To advance practice, further understanding of the active ingredients of such interventions and implementation factors that lead to effectiveness are essential.

Method: This systematic review, an update from a previous review, included studies on any parenting or family intervention for children and adolescents aged 0-24, living in a low- or middle-income country, that quantitatively measured child or adolescent mental health outcomes.

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Health systems globally demand more competent workers but lack competency-based training programs to reach their goals. This study evaluates the effectiveness of a competency-based curriculum (EQUIP-FHS) for trainers and supervisors to teach foundational helping knowledge, attitudes and skills, guided by the WHO/UNICEF EQUIP platform, to improve the competency of in-service and pre-service workers from various health and other service sectors. A mixed-methods, uncontrolled before-and-after trial was conducted in Nepal, Peru, and Uganda from 2020 to 2021.

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Socios En Salud (SES) implemented the Thinking Healthy program (THP) to support women with perinatal depression before and during the COVID-19 pandemic in Lima Norte. We carried out an analysis of the in-person (5 modules) and remote (1 module) THP intervention. Depression was detected using PHQ-9, and THP sessions were delivered in women with a score (PHQ-9 ≥ 5).

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Article Synopsis
  • The COVID-19 pandemic has shifted psychological support from in-person to remote methods, like phone and video calls, often without sufficient training for practitioners.
  • A qualitative study was conducted with 27 practitioners from Nepal, Peru, and the USA to explore their experiences adapting to this new remote delivery system during the pandemic.
  • Key findings indicate that while remote support presents safety concerns, it also enhances practitioners' skills and highlights the need for new training approaches, suggesting that simulated role plays could help ensure effective care delivery.
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Ensuring that sustainable and effective mental health services are available for children and adolescents is a growing priority for national governments. However, little guidance exists on how to support service implementation. In Kenya, partnerships were formed among regional government, nongovernmental organizations, and universities to implement Ensuring Quality in Psychological Support (EQUIP)-Nairobi, a pilot project to train and supervise nonspecialists delivering psychological support to adolescents.

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Article Synopsis
  • The COVID-19 pandemic accelerated the need for remote psychological interventions, but there is no consensus on key competencies needed for effective training and supervision in this area.
  • A rapid review identified 10 essential skill categories necessary for delivering remote psychological services, focusing on communication, safety, confidentiality, and technology use.
  • The findings aim to inform global best practices for training in remote psychological interventions, highlighting the need for further research on standardized competencies.
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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.

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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.

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Aim: Identifying predictors for future onset of depression is crucial to effectively developing preventive interventions. We conducted a systematic review and meta-analysis to identify risk factors for first-onset depression among adolescents and young people.

Methods: We searched MEDLINE (Ovid), PsycINFO, Cochrane Database, Web of Science, Lilacs, African Journals Online and Global Health (July 2009 to December 2020) for longitudinal studies assessing risk factors for first-onset depression among adolescents and young people aged 10-25 years.

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Article Synopsis
  • Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, particularly through cortisol levels, is linked to major depressive disorder (MDD) in adolescents and young adults, although most research has focused on adults.
  • A systematic review and meta-analysis of global studies identified that elevated morning cortisol levels are associated with future MDD development, while other cortisol levels did not show significant differences between healthy individuals and those with MDD.
  • The study highlights that while high morning and nocturnal cortisol are risk factors for developing depression, they do not serve as biomarkers for individuals already suffering from MDD.
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Delivery of psychological and psychosocial treatments by non-specialists in low-and middle-income countries (LMIC) is a growing strategy to address the global mental health treatment gap. However, little is known about which competencies are essential for non-specialists to effectively deliver treatment. Psychotherapy research in high-income countries suggests that effective treatment requires competency in common factors.

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Article Synopsis
  • Scientists are studying how both body and environment affect depression in teens, but most research focuses only on one or the other and is mostly done in wealthy countries.
  • They found that certain physical changes in the body, like inflammation and brain differences, are linked to a higher chance of depression, especially if a person had a tough childhood.
  • More research is needed to help better understand and detect depression risks in young people, especially in countries that are not as wealthy, since there aren’t many studies that look at both body and environment together.
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A major challenge in scaling-up psychological interventions worldwide is how to evaluate competency among new workforces engaged in psychological services. One approach to measuring competency is through standardized role plays. Role plays have the benefits of standardization and reliance on observed behavior rather than written knowledge.

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Background: Depression is a leading contributor to disability-adjusted life-years because of early onset and chronicity throughout the lifecycle. It is crucial to identify early predictors of depression among adolescents and young people to effectively target prevention. A gap in the literature is a comprehensive systematic review of predictors of depression among adolescents around the globe, especially in low- and middle-income countries LMICs.

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Community-based mental health services are emphasized in the World Health Organization’s , the World Bank’s , and the Action Plan of the World Psychiatric Association. There is increasing evidence for effectiveness of mental health interventions delivered by non-specialists in community platforms in low- and middle-income countries (LMIC). However, the role of community components has yet to be summarized.

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Bulimia nervosa (BN) emerges in the late teen years and is characterized by binge eating and related compensatory behaviors. These behaviors often co-occur with periods of negative affect suggesting an association between emotions and control over eating behavior. In the current study, we examined how cognitive control and neural processes change under emotional states of arousal in 46 participants with (n=19) and without (n=27) BN from the ages of 18-33 years.

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Typically in the laboratory, cognitive and emotional processes are studied separately or as a stream of fleeting emotional stimuli embedded within a cognitive task. Yet in life, thoughts and actions often occur in more lasting emotional states of arousal. The current study examines the impact of emotions on actions using a novel behavioral paradigm and functional neuroimaging to assess cognitive control under sustained states of threat (anticipation of an aversive noise) and excitement (anticipation of winning money).

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Individuals learn which of their actions are likely to be rewarded through trial and error. This form of learning is critical for adapting to new situations, which adolescents frequently encounter. Adolescents are also greatly influenced by their peers.

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