The Experiences of Counsellors Offering Problem-Solving Therapy for Common Mental Health Issues at the Youth Friendship Bench in Zimbabwe

Abstract

There is growing evidence that lay health workers providing counselling is a feasible approach of addressing the universally large treatment gap for mental disorders. This study illuminates the experiences of the counsellors in the Youth Friendship Bench in Zimbabwe, a pilot project where students provide problem-solving therapy to adolescents with common mental disorders. Twelve interviews were analysed using content analysis. The first theme "Working in a meaningful project" describes how the counsellors managed to create an alliance with the clients. The project was perceived as helpful, meaningful and urgent, and the counsellors' experienced a professional and individual development through the support of the Friendship Bench organization. The second theme "Encountering obstacles" illuminates how counsellors experienced situations where they failed to reach out to clients, felt unprepared and inadequate, and how they combated preconceptions and taboos. In the third theme, "Carrying an emotional burden," the counsellors described experiences of recognising own problems and empathising with the client.

“Seeing a Brighter Future” – Experiences of Adolescents with Common Mental Disorders Receiving the Problem-Solving Therapy “Youth Friendship Bench” in Zimbabwe

“…This study is unique in that it was conducted on patients in a low-resource setting where the therapy method had been contextualised to the culture of a LMIC (Chibanda et al, 2011) and to adolescents. Participants in the present study described a mental health stigma, consistent with previous findings in Zimbabwe (Pitorak et al, 2012;Wallén et al, 2021). In a similar Zimbabwean study, ten adults with HIV were interviewed on their experiences of FB (Chibanda et al, 2017).…”

“…They emphasised feelings of relief, problem-solving support, empowerment and achievement (Chibanda et al, 2017), in line with the results in the present study. The initial mistrust being transformed into a therapeutic alliance was experienced also by the YouFB counsellors (Wallén et al, 2021). Our results are also reflected in qualitative studies on adolescents' experiences of depression and psychotherapy conducted in Western countries (Dundon, 2006;McCarthy et al, 2008;Weitkamp et al, 2016).…”

“…YouFB is adapted from FB to address adolescents aged 16-19, and the issues typical of that age like relationships, sexuality, young parenthood and bullying (Verhey & Turner, 2018). In contrast to the "grandmothers" in FB, YouFB has younger LHW comprised mainly of psychology and sociology students doing a 1-year internship at the YouFB before their final year of education (Wallén et al, 2021). YouFB delivers PST not only at clinic sites, but also in public parks and other community settings, targeting vulnerable populations like pregnant teenagers and offenders.…”

“…The therapy of 4-6 weeks is followed by 6 weeks of CKT where participants share their experiences in a safe forum. A recent study exploring the experiences of YouFB counsellors found that counselling was perceived as meaningful and a source of personal and professional growth, but also that connecting with the client could be stressful and yield feelings of inadequacy (Wallén et al, 2021). One still unpublished mixed-method pilot study (Chibanda et al, 2018) has been conducted on YouFB, focussing on uptake, acceptability, adherence, effectiveness and cost-effectiveness of the intervention.…”

“…To our knowledge, there is no other effective, evidence-based and low-cost treatment strategy for adolescents with CMD in Africa. A recent article illuminated the counsellors' experiences of YouFB (Wallén et al, 2021), but no study has yet focussed on the experiences of youth attending the project. The aim of this study was to illuminate adolescents´ experiences of the YouFB.…”