Self-Help Plus

Domain V · Systemic, relational, group & community · Russ Harris, Epping-Jordan, Brown · 2016

What it is

SH+ is not a psychotherapy delivered by a clinician. It is WHO's five-session, guided self-help stress management course for groups of up to 30 adults, delivered by trained and supervised non-specialist facilitators using pre-recorded audio and the illustrated book. It is transdiagnostic, based on…

Format

• Format. Five sessions, each about 2 hours, once a week (about 5 weeks). WHO describes groups of up to 30; trials used 20–25 (Uganda protocol), 20–30 (Uganda trial) and 10–40 (RE-DEFINE, single-gender to fit cultural norms and preferences). Two facilitators run each group; in the Uganda pilot one…
• Sessions and skills. WHO lists five core skills in this order, and the course has one audio file per session:

Who practises it, and how they are trained or regulated

• Facilitators, training, supervision and licensing. Facilitators are non-specialists, ideally from the participants' community or a similar culture, with some experience in health, social, psychosocial, community or volunteer work; the Uganda trial also required completed secondary education and fluency in the delivery language. Two facilitators run each group. Reported facilitator training is about 5 days in person:…
• Version followed: WHO Self-Help Plus (SH+): a group-based stress management course for adults (2021, ISBN 9789240035119; English audio Sessions 1–5 plus an "Alternative Session 1"), used with the WHO illustrated guide Doing What Matters in Times of Stress (2020) and the SH+ training manual (WHO, 2024, ISBN 9789240095052). The participant exercises below are checked against the illustrated guide itself (WHO 2020,…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• 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?
• 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

• check the facilitator manual for when to use it.
• people already overextended in caring roles; balance with self-kindness.
• distress that rises during the course; re-assess and refer at any session.
• facilitators carrying risk alone or offering counselling beyond their role.
• adaptations that change the skills themselves rather than their language and examples.

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.