Piloting a Near-Peer Lay Counselor Based Problem Solving Therapy Intervention for Youth With and Without HIV in Botswana: An Adaptation of the Friendship Bench.

The adolescent mental health treatment gap is a significant public health challenge, especially in low-resource settings where services are often adult-oriented. The Safe Haven intervention, adapted from Zimbabwe's Friendship Bench, addresses this gap by leveraging near-peer youth lay counselors tra...

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Published in:Journal of Adolescent Health Vol. 78; no. 4; pp. 639 - 648
Main Authors: Brooks, Merrian J., MacLean, Sarah A., Eschliman, Evan L., Poku, Ohemaa B., Molebatsi, Keneilwe, Ahmed, Charisse, Morakanyane, Phenyo, Entaile, Patlo, Monyane-Pheko, Makhetha, Morapedi, Kealeboga, Phoi, Onkemetse, Tshume, Ontibile, Benton, Tami D., Matshaba, Mogomotsi, Lowenthal, Elizabeth D.
Format: research Journal Article
Published: Elsevier B.V. Apr2026
Online Access:View this record in EBSCOhost
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      jtl: Journal of Adolescent Health
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      dt: Apr2026
      vid: 78
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      pub: Elsevier B.V.
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        192259981
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        192259981
        10.1016/j.jadohealth.2025.12.260
        192259981
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        atl: Piloting a Near-Peer Lay Counselor Based Problem Solving Therapy Intervention for Youth With and Without HIV in Botswana: An Adaptation of the Friendship Bench.
      aug:
        au:
          Brooks, Merrian J.
          MacLean, Sarah A.
          Eschliman, Evan L.
          Poku, Ohemaa B.
          Molebatsi, Keneilwe
          Ahmed, Charisse
          Morakanyane, Phenyo
          Entaile, Patlo
          Monyane-Pheko, Makhetha
          Morapedi, Kealeboga
          Phoi, Onkemetse
          Tshume, Ontibile
          Benton, Tami D.
          Matshaba, Mogomotsi
          Lowenthal, Elizabeth D.
        affil: Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
      sug:
        subj:
          Mental Health Services In Adolescence
          Peer Group
          Counselors
          Problem Solving
          HIV-Positive Persons
          Friendship
          Program Evaluation
          Treatment Outcomes
          Child
          Adolescence
          Adult
          Botswana
          Questionnaires
          Scales
          Pretest-Posttest Design
          Human
          Wilcoxon Rank Sum Test
          Anxiety
          Depression
          Child: 6-12 years
          Adolescent: 13-18 years
          Adult: 19-44 years
      ab: The adolescent mental health treatment gap is a significant public health challenge, especially in low-resource settings where services are often adult-oriented. The Safe Haven intervention, adapted from Zimbabwe's Friendship Bench, addresses this gap by leveraging near-peer youth lay counselors trained in Problem-Solving Therapy. This study evaluates the feasibility and outcomes of Safe Haven across three sites in Botswana. Participants aged 12–25 years (N = 115) were recruited from clinical and community sites. Pre-intervention and post intervention assessments using the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Shona Symptom Questionnaire measured depression, anxiety, and common mental disorder symptoms. Pre/post differences in scores were statistically tested using Wilcoxon signed-rank tests. Significant reductions were observed in all mental health outcomes. Over four to six sessions (4–16 weeks), median Patient Health Questionnaire-9 scores decreased from 6 (interquartile range [IQR] 4–11) to 1 (IQR 0–3) (p <.001), with 78% showing improvement, and moderate depression symptoms reduced from 29% to 3%. Generalized Anxiety Disorder-7 scores decreased from 9 (IQR 7–12) to 2 (IQR 0–7), with 86% improving, and moderate or severe anxiety symptoms declined from 47% to 9%. Shona Symptom Questionnaire scores decreased from 10 (IQR 7–14) to 1 (IQR 0–4) (p <.001), with 93% improving. Safe Haven demonstrates potential in addressing Botswana's youth mental health needs, including underserved groups such as younger adolescents and those living with HIV. Although limitations include the prepost design and small sample size, findings support further scaling and controlled evaluations to optimize impact across diverse settings and populations.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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