Acceptability of Self-Help Plus and Problem Management Plus interventions among clients and implementation insights from staff of Opioid Agonist Treatment programs in Ukraine

Self-Help Plus (SH+) and Problem Management Plus (PM+) are two scalable psychological interventions developed by the World Health Organization to reduce stress, improve emotional regulation, and strengthen coping skills among adults experiencing adversity. SH+ is a low‑intensity, group‑based stress‑management course, while PM+ is a brief, individual intervention focused on problem‑solving and behavioural activation. This study explores the acceptability of SH+ and PM+, among staff providing psychosocial support and clients of the opioid agonist treatment (OAT) programs in Ukraine during wartime. A qualitative study was conducted using semi-structured interviews with 12 clients, alongside an analysis of meeting notes from monthly staff management discussions. 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. The SH+ group format created a supportive atmosphere, which contributed to the outcomes despite initial challenges with client engagement. Participants noted that even passive attendance in program sessions was associated with positive impacts, reflecting the intervention’s suitability for clients who struggle with active participation. The key advantage of PM+ was its flexibility in scheduling, which was beneficial given many clients’ unpredictable and chaotic life situations. The personalized nature of PM+ facilitated open dialogue and a deeper exploration of clients’ needs. Clients responded positively to the individual format of PM+, finding it familiar and comfortable. They appreciated the opportunity to be heard in a relaxed and confidential setting. Overall, the study indicates that SH+ and PM+ are acceptable, feasible, and valued by both clients and staff, supporting their potential integration into routine OAT services to help address unmet mental health needs during wartime.