Summary description: The Friendship Bench model employs a unique approach to address mental health challenges. It consists of sessions of culturally adapted problem soliving therapy for common mental health disorders delivered by a trained lay counsellor on a bench in a discreet area. Following this one-on-one structured talk therapy, clients are introduced to a peer-led support group called Circle Kubatana Tose (CKT), which translates to ‘holding hands together.’ In these groups, individuals connect with others who have also sat on the Friendship Bench, received PST, and gained empowerment to solve their own problems. The safe space for open dialogue fosters a sense of belonging and reduces stigma associated with mental health issues and personal sharing.

Access to the intervention manual: Contact Dixon Chibanda at dixon.chibanda@friendshipbench.io

Access to training: Contact Dixon Chibanda/Ethel Manda at dixon.chibanda@friendshipbench.io/ ethel.manda@friendshipbench.io

Intended users/ Implementers: Trained and supervised non-specialist provider

Therapeutic strategies: Problem solving, behaviour activation, social connectedness

Intervention format: The Friendship Bench intervention comprised 6 sessions of individual problem-solving therapy delivered by trained, supervised LHWs plus an optional 6-session peer support program. The control group received standard care plus information, education, and support on common mental disorders.

Target population: Adults (18+) with common mental health disorders

Significant effects found on symptoms of: Among 573 randomized patients (286 in the intervention group and 287 in the control group), 495 (86.4%)were women, median age was 33 years (interquartile range, 27-41 years), 238 (41.7%) were human immunodeficiency virus positive, and 521 (90.9%) completed follow-up at 6 months. Intervention group participants had fewer symptoms than control group participants on the SSQ-14 (3.81; 95% CI, 3.28 to 4.34 vs 8.90; 95% CI, 8.33 to 9.47; adjusted mean difference, −4.86; 95% CI, −5.63 to −4.10; P < .001; adjusted risk ratio [ARR], 0.21; 95% CI, 0.15 to 0.29; P < .001). Intervention group participants also had lower risk of symptoms of depression (13.7%vs 49.9%; ARR, 0.28; 95% CI, 0.22 to 0.34; P < .001).

Key innovative or differentiating features of this intervention: With over 100 peer-reviewed scientific publications and over 10 years of research, the Friendship Bench stands out as a home grown solution from the Global South to address the treatment gap for mental, neurological and substance use disorders. Our seminal publication of the randomized controlled trial (RCT), in JAMA in 2016 demonstrated an 80% reduction in depression and suicidal ideation and a 60% improvement in quality of life, 6 months after receiving therapy from a trained community grandmother, affectionately referred to as ambuya utano. It is against this publication and numerous others that Friendship Bench has become the most sought-after intervention aimed at addressing the treatment gap for common mental disorders - invited regionally, in the USA, UK, South America and beyond to replicate the model in new settings. We are on a mission to get people out of depression and we envision a friendship bench within a walking distance for all.

Different populations where the intervention has been used: Adults 18+

Examples of adaptations and different formats: In Zimbabwe - Adolescents and young adults (15-24years) Youth Friendship Bench (https://www.tandfonline.com/doi/pdf/10.1080/01612840.2021.1924323 and https://www.tandfonline.com/doi/pdf/10.1080/01612840.2021.1879977), Adults 18+ living positively with HIV (https://doi.org/10.1371/journal.pgph.0001492) and online sessions (https://s3.ca-central-1.amazonaws.com/assets.jmir.org/assets/preprints/preprint-37968-submitted.pdf). Outside Zimbabwe - Mobile application in Kenya (https://www.cambridge.org/core/services/aop-cambridge-core/content/view/BA0F3D4B9ABA077EEFF634A9D951CBD8/S2054425121000030a.pdf/div-class-title-a-community-health-volunteer-delivered-problem-solving-therapy-mobile-application-based-on-the-friendship-bench-inuka-coaching-in-kenya-a-pilot-cohort-study-div.pdf), Adaptation of a Problem-solving Program (Friendship Bench) to Treat Common Mental Disorders Among People Living With HIV and AIDS and on Methadone Maintenance Treatment in Vietnam (http://www.ncbi.nlm.nih.gov/pubmed/35802402). In Africa - Malawi, Zambia and Zanzibar. Adaptation in USA - Washington DC (Help Age) and New Orleans. Adaptation in UK - South of London - LSTMH.

Information provided by Dixon Chibanda on 19 August 2024. He is the autor.