Self Help Plus (SH+)

The Self Help Plus (SH+) programme was developed by WHO and collaborators working in the humanitarian field, with expertise in global mental health and psychosocial interventions. SH+ programme consists of a pre-recorded audio course, complemented with bibliotherapy, and thanks to this format not requiring much time from experts for implementation.

The potential of using a psychoeducational course to access hard-to-reach populations has been demonstrated previously. Furthermore, research has found that guided self-help programs produce much better results than “pure” (unguided) selfhelp, and the effects produced by guided self-help are surprisingly similar to face-to-face psychological treatment.

SH+ was designed to be relevant for large segments of adversity-affected populations: it is intended to be transdiagnostic, easily adaptable to different cultures and languages, and both meaningful and safe for people with and without mental disorders.

The SH+ programme has two components: a pre-recorded course and a self-help book.

Pre-recorded audio material (locally adapted) is delivered across five 2-hour sessions and in groups of 20 to 30 people. The audio material imparts key information about stress management and guides participants through individual exercises and small group discussions. A written facilitator guide helps briefly trained non-specialist facilitators to conduct the course using these audio materials. To augment the course materials, an illustrated self-help book reviews all essential content and concepts. The book –contains more than 400 illustrations and conveys key points with minimal text. It was written to be useful both as a standalone product and as a key resource for those participating in the course.

The format of SH+ is innovative in that it seeks to ensure that key intervention components are delivered as intended through the use of pre-recorded audio, without the burden of extensive training and supervision. SH+ programme is based on acceptance and commitment therapy (ACT), a form of cognitive-behavioral therapy, with distinct features (53). ACT is based on the concept that ongoing attempts to suppress unwanted thoughts and feelings can paradoxically make these problems worse. Instead, it emphasises learning new ways to accommodate difficult thoughts and feelings – primarily through mindfulness approaches – without letting them dominate, while guiding people to take proactive steps towards living in a way that is consistent with their values. ACT has been shown to be useful for a range of mental health issues and has been used successfully in a guided self-help format.

Read more about SH+ on the Mental Health Innovation Network website