Problem Management Plus

Domain V · Systemic, relational, group & community · Katie Dawson · 2016

What it is

PM+ is a WHO low-intensity, transdiagnostic psychological programme for adults whose daily functioning is impaired by distress (depression, anxiety, stress-related symptoms) in communities exposed to adversity such as conflict, violence, poverty or disaster. It was designed for task-sharing:…

Format

• Delivery format (individual PM+, v1.1). Pre-PM+ assessment (about 60 min) → five weekly individual sessions of about 90 min → post-PM+ assessment within a few weeks of ending, with a follow-up around three months later recommended. Home practice between all sessions. Family members or friends may…
• Session-by-session plan (individual, approximate minutes from the manual's time guide):

Who practises it, and how they are trained or regulated

• Training, supervision and certification. Non-specialist helpers: at least 80 hours (10 days) of classroom training, then at least two supervised practice clients each taken through all five sessions (~15 hours); mental health professionals without CBT training: 40 hours (5 days) then two closely supervised cases. Group PM+: at least 96 hours of training for non-specialists, then at least two supervised groups (~20…

Evidence status, as the guide reports it

• How change is meant to happen: the client learns four practical, evidence-informed strategies (slow breathing to manage stress; structured problem solving for practical problems; behavioural activation to break the inactivity–low mood cycle; strengthening social support), practises them between…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Ability to explain a strategy suggests it has been learned.
• The client crediting change solely to the helper; return credit to their own practice.
• Relief and recognition in the client ("so I'm not the only one") suggests it has landed.
• Sadness at ending is normal; anxiety about ending can be met with the Staying Well plan.
• Unrecorded dropouts; arrange the post-assessment soon after dropout and record the reason.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.