An evaluation of non-specialist training and delivery of a brief cognitive-behavioral therapy-based transdiagnostic intervention for adolescents with depression and anxiety in Nairobi, Kenya.

This study evaluated 1) foundational helping competencies for Non-Specialist Providers (NSPs) trained in a transdiagnostic CBT-based intervention (PRO-ACT) for adolescents with anxiety and depression in Nairobi, Kenya and 2) preliminary clinical outcomes for adolescents receiving PRO-ACT. Seventeen NSPs were trained and assessed using role plays at pre-training, post-training, and post-supervision using the Enhancing Assessment of Common Therapeutic Factors (ENACT) tool, via a pre-post design (no control group). Eighteen adolescents were enrolled, received 4-6 PRO-ACT sessions, and assessed using the Patient Health Questionnaire-9 (PHQ-9) and Revised Children's Anxiety and Depression Scale (RCADS-25). There were no significant changes in NSPs' competencies from pre- to post-training. From pre-training to post-supervision, NSPs' Level 1 (Potentially harmful) scores significantly decreased (-1.12 items; 95% CI: -2.10, -0.15; p = 0.026) and Level 3 or 4 ("Basic" or "Advanced competency") significantly increased (2.12; 95% CI: 1.21, 3.04; p < 0.001). Adolescents had no significant change in mean PHQ-9 scores. RCADS scores decreased significantly for depression (-3.00 points; 95% CI: -5.45, -0.55; p = 0.020) and anxiety (-3.39 points; 95% CI: -6.17, -0.61; p = 0.020). NSPs' foundational helping competencies improved significantly during clinical supervision. Client outcomes were promising, warranting a larger rigorous trial.