Effectiveness of Self-Help plus and problem management plus interventions in providing psychological support to clients of Opioid Agonist treatment programs in Ukraine

Background
The paper presents an effectiveness study of two World Health Organization (WHO) scalable psychological interventions, Self-Help Plus (SH+) and Problem Management Plus (PM+), for the patients of the Opioid Agonist Treatment (OAT) programs in Ukraine during wartime.

Method
The study (pragmatic trial) was designed as an experiment with two intervention groups (for SH+ and PM+) and one control group (waiting list). The GAD-7, PHQ-9, LEC-5, and PCL-5 scales were used for the outcomes’ screening three times (before, immediately after, and three months after the intervention). In addition, the number of missed visits on-site for medication in the last month was counted, and dose satisfaction was assessed. Data were collected from April to October 2023 (during the second year of the full-scale Russian invasion of Ukraine) at OAT centers in Lviv, Sumy, and Vinnytsia.

Results
Both interventions showed promising improvements in mental health outcomes within their groups, though no statistically significant differences were observed between intervention and control groups. The SH+ showed additional benefits, a decrease in missed medication doses, and a reduction in PTSD and depression symptoms.

Conclusions
The findings demonstrate the potential for scalable psychological interventions to be integrated into OAT programs to address the dual challenges of mental health and OAT adherence in resource-limited and crisis-affected settings.