The Effectiveness of Counseling on Anxiety and Depression by Minimally Trained Counselors: A Randomized Controlled Trial

Objective: To assess if eight counseling sessions conducted by women minimally trained as community counselors could reduce the mean level of anxiety and/or depression in women of their own community. Design: A randomized controlled trial. Setting: A lower-middle-class, semi-urban community in Karachi, Pakistan. Participants: 366 anxious and/or depressed women providing informed consent. Method: Through systematic sampling, 1226 women were screened using an indigenous instrument. Out of these, 366 women were found to have anxiety and/or depression and were randomized to intervention and control groups. Women from the same community were trained in 11 sessions as counselors. Subjects in the intervention group were counseled once weekly for eight weeks by the trained community counselors. After the 8^th session, the screening questionnaire was re-administered to both the groups. Results: A significant reduction was found between the mean anxiety and depression scores of the two groups (p value = 0.000). Conclusion: Counseling by minimally trained community counselors reduced levels of anxiety and/or depression in women of their own community.