Adapting group interpersonal psychotherapy for a developing country: experience in rural Uganda.

TLDR

Depressive symptoms affect up to 21 % of people in Southwest Uganda, where limited physician access, high medication costs, and ineffective traditional healers make pharmacotherapy unfeasible, and the cultural relevance of interpersonal triggers is recognized. The study aimed to adapt interpersonal psychotherapy for rural Uganda and report the manual adaptation and training of group leaders for the first African IPT‑G trial. Interpersonal psychotherapy in a group format was chosen for its time‑limited, manualized, evidence‑based nature, and a randomized controlled trial was designed to evaluate its implementation by trained local leaders.

Abstract

The current prevalence of depressive symptoms in Southwest Uganda, an area greatly affected by the HIV epidemic, has been shown to be as high as 21%. Traditional healers have expressed inability to treat these symptoms. The lack of physicians and high cost of medication make the use of antidepressants unfeasible. Therefore, an evidence-based psychotherapy was considered a reasonable treatment option by a team of health researchers familiar with the local culture, who designed a randomized controlled clinical trial. Interpersonal psychotherapy in a group format (IPT-G) was selected because it was time limited, was described in a manual, and had evidence of efficacy from clinical trials. Moreover, its focus on interpersonal triggers of depression was considered compatible with the culture. This paper describes the process of adapting the psychotherapy manual and the training of the group leaders who undertook the first psychotherapy clinical trial in Africa.