Summary description: Doing What Matters in Times of Stress (DWM) is an illustrated self-help stress management guide that is one part of Self-Help Plus (SH+), a WHO group stress management course and can be used alone or with the accompanying audio exercises.The DWM guide can be delivered as a guided self-help intervention with support from a briefly trained non-specialised helper. It is based on acceptance and commitment therapy (ACT). when delivered as a guided self-help intervention DWM has been shown to reduce psychological distress making it suitable for adults experiencing stress. Evidence suggests that DWM can complement other mental health interventions as an initial step in a stepped care program.
**Access to the intervention manual: ** Available online, contact WHO at: psych_interventions@who.int for any further enquiries.
Access to training: Training manual for providing DWM as guided self-help is available on request from psych_interventions@who.int. manual and training will be published in 2025.
Intended users/ Implementers: Self-help guide. Can also be delivered as guided self help intervention by trained non-specialist workers.
Therapeutic strategies: DWM is based on Acceptance and Commitment Therapy (ACT), a form of CBT with distinct features. It provides training in five skills used to help people manage stress. These five core skills are – Grounding in stressful situations, Unhooking from difficult thoughts and feelings, Acting on your values, Being kind (related to social support), and Making room (a mindfulness exercise).
Intervention format: The DWM guide is a booklet with images and small amounts of text and has accompanying audio recordings to support users to use the techniques described. All materials can be freely downloaded from the WHO website. It has also been adapted for delivery as an online digital application. It can be delivered with guidance from trained non-specialist helpers in different ways. One pilot trial with Syrian refugees provided three calls while other trials (in press) provided up to 15 mins for up to 5 sessions over the telephone.
Target population: Populations affected by adversity, including refugees and people affected by a humanitarian emergencies.
Significant effects found on symptoms of: A pilot RCT showed effects when DWM is delivered as a guided self-help intervention for and post-traumatic stress symptoms.
Key innovative or differentiating features of this intervention: DWM can be delivered either as a self-help or guided self help intervention. When delivered as a guided self-help intervention, the use of a booklet and pre-recorded materials ensures consistency and means training and supervision may be shorter compared to other psychological interventions. The intervention can also be adapted for other means of delivery e.g. presented as an online intervention rather than a printed booklet.
Summary of Evidence: DWM has been evaluated in one randomised controlled pilot trial in Turkey with Turkish nationals and Syrian refugees. Further trials are in press where DWM was part of stepped care model in Europe with migrant populations.
Different populations where the intervention has been used: Refugees and asylum seekers.
Restrictions or requirements for its use: DWM is not suitable for people who have a severe impairment related to a mental, neurological or substance use disorder, or are at imminent risk of suicide (e.g. people with a plan to end their life in the near future). It may be considered as an additional intervention, when other needs are fully addressed. Supervisors and trainers are ideally mental health professionals who are competent and experienced in delivering psychological interventions or guided self-help.
Requirements / qualifications for trainers and supervisors: When delivered as a guided self-help intervention supervisors and trainers of helpers are mental health professionals who are competent and experienced in delivering psychological interventions or guided self-help.
Examples of implementation outside of RCT contexts: DWM has been adapted to be delivered as an online intervention and made available publicly with a focus on the Ukraine crisis by Vrijie Universitet Amsterdam: https://dwmatters.eu/
Information provided by James Underhill on 5 November 2024. He is the WHO focal point for DWM.