Overview

Problem Management Plus (PM+) is a 5-session, individual psychological intervention program developed by the World Health Organization (WHO) and delivered by paraprofessionals. The program addresses common mental disorders among individuals affected by adversity.

The term “problem management” is used rather than “problem-solving” to highlight that many practical problems encountered by people living with adversity may not necessarily be solvable. The “plus” refers to the evidence‐based behavioral strategies that enhance one’s capacity to adaptively manage emotional problems.

This program aims to reduce symptoms of depression, anxiety, PTSD, and stress in the wake of adversity and trauma as well as self‐identified practical problems (e.g., unemployment, interpersonal conflict). It comprises of several evidence-based techniques: (a) problem solving, (b) stress management, (c) behavioral activation, and (d) accessing social support.

One of the core features of PM+ is adherence to a transdiagnostic approach. Transdiagnostic treatments are “those that apply the same underlying principles across mental disorders, without tailoring the protocol to specific diagnoses. This approach can be very useful, as most people present with comorbidity. Addressing multiple problems at one time through shared emotional mechanisms is more efficient.

Objectives

• Learn motivational interviewing techniques to improve engagement.
• Recognize common reactions to adversity and learn basic stress management strategies.
• Learn problem-solving techniques and behavioral activation procedures.
• Learn strategies to strengthen social support networks.
• Learn how to retain treatment gains.

How does it work?

The program consists of 5 weekly sessions lasting 90 minutes each.

Session one orients participants to the program with motivational interviewing techniques to improve engagement. It provides psychoeducation about common reactions to adversity and teaches participants basic stress management strategies. This strategy is practiced at the conclusion of every subsequent session to enhance learning.

Session two addresses a participant-selected problem through the provision of problem-solving techniques and introduces behavioral activation procedures. Sessions three and four continue to support participants’ application of problem-solving, behavioral activation, and relaxation exercises, and it introduces strategies to strengthen social support networks. Finally, session five explains retaining treatment gains, reviews all learned strategies, and concludes the program.

We also provide six days of training in basic counseling skills and delivery of PM+ at our center. Weekly supervision will be provided by a PM+ Master trainer who is a clinical psychologist to provide support and ensure adherence to treatment.