Training and Supervising Lay Providers in Kenya: Strategies and Mixed-Methods Outcomes☆☆☆

ObjectiveTraining lay providers to deliver mental health interventions is both effective and cost-effective. However, more research is needed to document training and supervision procedures and to collect lay providers’ feedback.MethodsThis study documents training and supervision from a randomized controlled trial of the Shamiri intervention, a four-session, school-based intervention that significantly reduced symptoms of anxiety and depression in Kenyan adolescents. We delivered a 10-hour training to 13 lay providers, M (SD)_age = 21.00 (1.95), %_female = 61.54. We also hosted 30-minute supervision meetings twice weekly. Training and supervision were delivered primarily by undergraduates. Independent raters coded session recordings for fidelity and quality of services, and we collected quantitative and qualitative feedback from lay providers.ResultsReliability and mean ratings for all six of our fidelity and quality measures (delivering required content, adhering to specified details, thoroughness, skillfulness, clarity, and purity) were very good to excellent. Lay provider quantitative ratings of training were also overwhelmingly positive, with an overall satisfaction rating of 6.46/7.00. We identified central qualitative themes in lay provider comments: Generally, comments about training style, content, and personal interactions were overwhelmingly positive, and many lay providers reported personal growth. Comments about timing and location of training were mixed.ConclusionsThis study provides preliminary evidence that a very brief training delivered primarily by undergraduates can teach high school-graduate lay providers to deliver effective mental health interventions. Additionally, we discuss lessons learned and implications for future research, including the importance of considering local context when planning and of continuously collecting and addressing lay provider feedback.     

Qu’est-ce que les professionnels dévoilent d’eux-mêmes dans la relation thérapeutique avec les personnes atteintes de schizophrénie ?

IntroductionHealth professionals’ self-disclosure is a common practice, but there is still controversy regarding when it is appropriate, what the extent and content of self-disclosure should be, and what the clinical consequences are.ObjectivesThis qualitative study aimed to investigate self-disclosure in health and social-care professionals.MethodThirteen in-depth interviews with group leaders of an intervention to improve pleasure and motivation in schizophrenia. The interviews were subjected to thematic analysis.ResultsProfessionals describe their personal disclosures as authentic sharing of lived experiences. From a content point of view, professionals select simple events from their personal or professional life, which they find easy to share with patients, in a group. The selection criteria for these experiences mainly concern the therapeutic value and are formulated in terms of relevance of the content and the usefulness envisioned for the patient as well as authenticity. Self-disclosure generates a redefinition of the places in interaction and a more egalitarian relationship.ConclusionSelf-disclosure is found to be a tool for developing and maintaining the therapeutic relationship. Further studies of the phenomenon would be useful to design training and supervision for professionals.     

The mathematics of sharing / Las matemáticas que realizan los niños al compartir

Abstract

The purpose of sharing is to construct equivalent sets, making it an ideal context for analysing important quantitative concepts such as counting, equivalence and cardinality. Two studies analysed how four- and five-year-olds shared blocks in equal sharing and reciprocity conditions and their number inferences about one set after counting the other. The researcher asked children to share double and single blocks between two characters. They succeeded more in building equivalent shares in an equal sharing than reciprocity condition. Most children who shared correctly also made appropriate number inferences. To examine whether perceptual cues helped children share the blocks, a second study used Canadian $1 and $2 coins. A double block is twice the size of a single, whereas there is no visual cue about the value relation between coins because they are the same size. Unexpectedly, children shared equally well with blocks and coins, and most children made number inferences.     

Sharing without caring? Respect for moral others compensates for low sympathy in children's sharing

We examined links between sharing, respect for moral others, and sympathy in an ethnically diverse sample of 7‐ and 15‐year‐olds (N = 146). Sharing was assessed through children's allocation of resources in the dictator game. Children reported their respect towards hypothetical characters performing moral acts. Sympathy was evaluated via caregiver and child reports. Respect and caregiver‐reported sympathy interacted in predicting sharing: Higher levels of respect were associated with higher levels of sharing for children with low, but not medium or high, levels of sympathy. The motivational components of other‐oriented respect may compensate for low levels of sympathetic concern in the promotion of sharing.