2011 Theses Doctoral

Community Impact of Group Interpersonal Psychotherapy in Rural Uganda

Lewandowski, Robert Eric

The objective of this study was to investigate the impact of a long-standing Group Interpersonal Psychotherapy (IPT-G) program for the treatment of depression in rural Ugandan communities as perceived by local people, and to assess its effect on broad outcomes related to health, and economic and social development. Studies evaluating depression treatments in low-income countries usually focus on symptom remission and do not consider such broader effects in the community. The study was conducted in poor, severely HIV/AIDS affected communities where the rate of depression reached 21%. Former IPT-G participants, their family members, and other community members were interviewed using qualitative free-listing and key-informant interviews. Respondents identified 5 important categories of change in the community related to the IPT-G program: 1) Improved school attendance for children; 2) Improved productivity in agriculture and animal husbandry; 3) Improved sanitation in communities; 4) Greater cohesion among community members; 5) Reduced conflict in families. Key-informant interviews with knowledgeable community members and IPT-G facilitators and staff suggested that as depression remitted, IPT-G participants became more hopeful and motivated and resumed productive pursuits. Greater cohesion among group members led to collaborative farming and building efforts, and to continued mutual emotional support and peer counseling. Community changes reported in this study cannot uniquely be attributed the IPT-G treatment of depression program as development programs related to farming, sanitation, and education also operated in the study area. Nevertheless, results suggest that treating depression in communities where it is prevalent may contribute to improvement on a wide range of non-mental health outcomes.