Browsing by Author "Kraaij, Vivian"

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    A booklet self-help intervention for people living with HIV and depressive symptoms in Botswana: a randomized controlled trial
    (AIDS and Behavior, 2025-04-29) Vavani, Boitumelo; Garnefski, Nadia; Luenen, Sanne van; Dusseldorp, Elise; Amone-P’Olak, Kennedy; Spinhoven, Philip; Kraaij, Vivian
    In low- and middle-income countries (LMICs), there is a scarcity of psychological treatment options for people living with HIV (PLWH) with depressive symptoms. Self-help programs for depressive symptoms, in particular, are cost-effective and scalable, and therefore a promising tool in the treatment of depressive symptoms for people in low-resourced countries. This paper presents the results of a study that examined the effectiveness of a guided self-help program in reducing depressive symptoms in PLWH in Botswana. A Randomized Controlled Trial (RCT) was conducted on a sample of PLWH who were screened at HIV treatment centers in Botswana. The RCT had two conditions: an intervention group that received the self-help program with coaching and an attention-only control group. In both groups, a pre-test, post-test, and 3-month follow-up measurement were administered. Patients in the intervention group followed a booklet Cognitive Behavioral Therapy (CBT)-based self-help program. Seventy-two participants were included in the study. The results indicated significantly larger decreases in depressive symptoms in the intervention group than in the attention-only control group, both in the short and longer term, with large effect sizes. In addition, there were significant reductions in anxiety symptoms in the intervention group compared to the control group. The user satisfaction was high. Implementing this low-cost and scalable self-help program in a LMIC such as Botswana is critical in bridging the existing mental health treatment gap. This clinical Trial was registered with the Netherlands Trial registry, number NTR5407on August 23, 2018. Keywords Depressive symptoms · Self-help · HIV · Randomized clinical trial · Low-and-middle income countries
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    The effectiveness of self-help interventions in the treatment of depressive symptoms in low-and-middleincome countries (LMICs): a meta-analysis
    (International Journal of Mental Health, 2025-05-12) Vavani, Boitumelo; Luenen, Sanne van; Garnefski, Nadia; Spinhoven, Philip; Amone-P’Olak, Kennedy; Witlox, Maartje; Kraaij, Vivian
    Background: Self-help psychological interventions show great potential to close the treatment gap for depressive symptoms in low-and middle-income countries (LMICs). The current meta-analysis investigated the pooled effect of self-help interventions for people with depressive symptoms in LMICs and moderators of these psychological interventions. Method: PubMed, Cochrane Register of Randomized Controlled Trials, PsychInfo, Embase, and Sabinet databases were searched between June 2021 and December 2022 to select studies that met pre-defined inclusion criteria. A coding protocol was used to retrieve and code relevant data from selected studies. We measured publication bias and assessed the study quality using the Cochrane Risk of Bias tool. The program ‘Comprehensive Meta-Analysis’ (CMA) was used for the data analysis. Overall effect sizes were calculated to assess the effectiveness of selfhelp programs for depression. Results: Eighteen studies were included in the meta-analysis. Self-help interventions were found to have a medium positive effect on depressive symptoms at post-test (Hedges’ g = 0.74) and at follow-up (Hedges’ g = 0.82). There was evidence for publication bias. Larger effects were found for studies that were conducted in lower-middle income countries, had at least mild depression as inclusion criterion, reported less than 30% attrition, did not use relaxation techniques, had a low or medium risk of bias, and that used a booklet form of intervention. Conclusion: This meta-analysis suggests that self-help interventions have a positive effect on people with depressive symptoms in LMICs. The findings could inform the design and implementation of mental health interventions that could prevent or treat depression.
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    The effectiveness of self-help interventions in the treatment of depressive symptoms in low-andmiddle- income countries (LMICs) : a meta-analysis
    (International Journal of Mental Health, 2025-05-12) Vavani, Boitumelo; Sanne, van Luenen; Garnefski, Nadia; Spinhoven, Philip; P’Olak, Kennedy Amone; Witlox, Maartje; Kraaij, Vivian
    Background: Self-help psychological interventions show great potential to close the treatment gap for depressive symptoms in low-and middle-income countries (LMICs). The current meta-analysis investigated the pooled effect of self-help interventions for people with depressive symptoms in LMICs and moderators of these psychological interventions. Method: PubMed, Cochrane Register of Randomized Controlled Trials, PsychInfo, Embase, and Sabinet databases were searched between June 2021 and December 2022 to select studies that met pre-defined inclusion criteria. A coding protocol was used to retrieve and code relevant data from selected studies. We measured publication bias and assessed the study quality using the Cochrane Risk of Bias tool. The program ‘Comprehensive Meta-Analysis’ (CMA) was used for the data analysis. Overall effect sizes were calculated to assess the effectiveness of selfhelp programs for depression. Results: Eighteen studies were included in the meta-analysis. Self-help interventions were found to have a medium positive effect on depressive symptoms at post-test (Hedges’ g = 0.74) and at follow-up (Hedges’ g = 0.82). There was evidence for publication bias. Larger effects were found for studies that were conducted in lower-middle income countries, had at least mild depression as inclusion criterion, reported less than 30% attrition, did not use relaxation techniques, had a low or medium risk of bias, and that used a booklet form of intervention. Conclusion: This meta-analysis suggests that self-help interventions have a positive effect on people with depressive symptoms in LMICs. The findings could inform the design and implementation of mental health interventions that could prevent or treat depression.