Cognitive Behavioral Therapy for Individuals With Low Literacy and Perinatal Depression

Is a culturally adapted cognitive behavioral therapy (CBT) program delivered by lay counselors from the local community efficacious for treating perinatal depression among women who are undernourished?In this randomized clinical trial of 155 perinatal women who were undernourished with depression in rural Sierra Leone, participants assigned to receive 6 sessions of CBT had lower depressive symptom scores after treatment compared with those receiving enhanced usual care but no counseling.These findings suggest that CBT adapted for low-literacy settings and delivered by lay counselors may offer a scalable model for evidence-based psychological treatment where mental health professionals are scarce.

Corresponding Authors: Mark J. Manary, MD, School of Medicine, Washington University, Manary Lab Room 5400, 4444 Forest Park Blvd, St Louis, MO 63108, St Louis, Missouri (manarymj@wustl.edu); Kevin B. Stephenson, MD, School of Medicine, Washington University, Manary Lab Room 5400, 4444 Forest Park Blvd, St Louis, MO 63108 (k.stephenson@wustl.edu).

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