Group-Based Cognitive Behavioral Therapy Training Improves Mental Health of SME Entrepreneurs : Experimental Evidence from Conflict-Affected Areas of Pakistan
Mental health, well-being, and lasting economic outcomes are intimately connected. However, in geographies marked by fragility, conflict, and violence (FCV), entrepreneurs of small and medium size enterprises (SMEs) experience chronic stress and poor mental health on a regular basis. These issu...
| Main Authors: | , , |
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| Format: | Working Paper |
| Language: | English |
| Published: |
World Bank, Washington, DC
2019
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| Subjects: | |
| Online Access: | http://documents.worldbank.org/curated/en/339861559669899428/Group-Based-Cognitive-Behavioral-Training-Improves-Mental-Health-of-SME-Entrepreneurs-Experimental-Evidence-from-Conflict-Affected-Areas-of-Pakistan http://hdl.handle.net/10986/31799 |
| Summary: | Mental health, well-being, and lasting economic outcomes
are intimately connected. However, in geographies marked
by fragility, conflict, and violence (FCV), entrepreneurs
of small and medium size enterprises (SMEs) experience
chronic stress and poor mental health on a regular basis.
These issues can hamper performance and quality of life
for the entrepreneurs, and can dampen the benefits of
existing financial and business assistance programs. Few
proven rigorous interventions are known. This study tests
the hypothesis that a five-week group Cognitive Behavioral
Therapy (CBT) training called Problem Management Plus
for Entrepreneurs (PM+E), in combination with financial
assistance, could be more effective at reducing psychological
stressors of SME entrepreneurs in FCV contexts
than financial assistance alone. Meaningful and statistically
significant improvements in mental health were achieved,
with improvements persisting and increasing beyond the
immediate post-intervention period. Based on analysis of
pooled data across two follow-up rounds (at five weeks and
three months post-intervention), entrepreneurs in the treatment
group experienced statistically significant reduction
in the intensity and prevalence of depression and anxiety
symptoms (measured by the Patient Health Questionnaire
Anxiety and Depression Scale) and higher levels of
well-being (measured by the World Health Organization
Well-Being Index) compared with the control group. The
effect was marked for those experiencing mild/moderate
levels of depression and anxiety, suggesting the clinical
value of such low touch interventions. Overall, the study
demonstrates that empirical research through Randomized
Control Trials (RCTs) can be conducted in challenging,
FCV settings through appropriate rapid training of local
researchers and non-specialist providers (NSPs) at a low
cost, yielding scalable programmatic and policy level lessons. |
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