Category: Cultural Diversity / Vulnerable Populations


Symposium 70 - Applying CBT in Low- and Middle-Income Countries: Trials, Advances, and Implementation Strategies

Saturday, November 18
9:45 AM - 10:45 AM
Location: Aqua Salon A & B, Level 3, Aqua Level

Keywords: Cultural Diversity/ Vulnerable Populations | Treatment-CBT | Clinical Trial
Presentation Type: Symposium

Children and adolescents (under 18 years) in low and middle income countries (LMIC) are exposed to challenges, traumas and stressors that increase their risk for mental health problems such as forced migration, forced labor, witnessing of murder and mass killings, lack of food and shelter, rape, torture, loss and separation from family, recruitment and use by armed forces, physical abuse, and family and sexual violence1-3. An increasing number of randomized controlled trials in LMIC have demonstrated the effectiveness of evidence-based treatments (EBTs), many CBT-based. However, few studies have focused on youth, attempted to extend CBT for mental health to include a focus on behavioral change for health conditions (HIV risk), or incorporated research questions that could inform how these CBT interventions can be scaled up for population reach and sustainment utilizing task sharing (wherein providers are not formally trained in mental health).  This symposium presents findings from studies of CBT-based interventions in five contextually diverse LMIC countries (Southern Iraq, Thai-Burma border, Zambia, Tanzania and Kenya). 

Dr. Shannon Dorsey will present treatment outcomes from a randomized controlled trial (RCT) of Trauma-focused CBT for children, with a focus on strategies for scale up.  Dr. Laura Murray will present results from a RCT in Zambia comparing psychosocial counseling and TF-CBT on HIV-risk behavior in adolescents, as well as mental health and implementation outcomes. Dr. Maythem Alsiary will join us from Iraq and present on a train-the-trainer implementation strategy tested in Iraq and Myanmar with an evidence-based transdiagnostic treatment model4. Finally, Dr. Beverly Pringle, an expert from NIH in global mental health, will discuss implications of the presented work for addressing the mental health treatment gap in LMIC, the current and future use of CBT, and future directions for the role of EBT in global mental health.


1 Lustig SL, Kia-Keating M, Knight WG, Geltman P, Ellis H, Kinzie JD, Keane T, Saxe GN.  Review of Child and Adolescent Refugee Mental Health. Journal of the American Academy of Child and Adolescent Psychiatry. 2004; 43(1), 24-36.

2Cluver, L.,& Gardner, F. The Mental Health of Children Orphaned by AIDS: A Review of International and Southern African Research. J Child Adoles Men Health. 2007; 19:1-17. 

3Patel V, Flisher AJ, Hedrick S, McGorry P. Mental health of young people: a global public-health challenge. The Lancet. 2007: 369 (9569), 1302 - 1313

Learning Objectives:

Send Email for Laura Murray

Beverly Pringle

Deputy Director, Office for Research on Disparities & Global Mental Health (ORDGMH) and Chief, Global Mental Health Research, ORDGMH
National Institute of Mental Health


    Send Email for Beverly Pringle

    Send Email for Laura Murray

    Shannon Dorsey

    Associate Professor
    University of Washington


    Send Email for Shannon Dorsey

    Maytham Al-Yasiry

    Specialist Psychiatrist, Lecturer
    Babylon University /College of Medicine


    Send Email for Maytham Al-Yasiry


    Symposium 70 - Applying CBT in Low- and Middle-Income Countries: Trials, Advances, and Implementation Strategies

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