Self-Help Plus (SH+) for Stress Reduction in Social Service Workers: A Pilot RCT

Condition(s) studied

Investigational drug(s) / intervention(s)

Self-Help Plus (SH+): WHO Self-Help Plus: a low-intensity, ACT-based guided self-help program delivered by trained non-specialist facilitators in a group format over five weekly sessions (approximately 2 hours each), using a pre-recorded audio course and the illustrated self-help book "Doing What Matters in Times of Stress."

Enhanced Care as Usual (ECAU): Continued access to existing institutional support and routine services plus a comprehensive psychoeducational information pack on stress-coping strategies, recognition of stress symptoms, and referral pathways to mental health and psychosocial support services

Study summary

This is a two-arm, stratified cluster-randomized controlled pilot trial evaluating the feasibility and preliminary effectiveness of the World Health Organization's Self-Help Plus (SH+) intervention for stress reduction among social service workers employed by the Istanbul Provincial Directorate of Family and Social Services (ASHP). Four institutions (clusters) are randomized 1:1, stratified by service type, to receive either SH+ plus Enhanced Care as Usual (ECAU) or ECAU only, with a target of 50 participants (25 per arm). The primary aim is to assess feasibility indicators (recruitment, session attendance, retention, and acceptability) to inform a future full-scale definitive trial. Preliminary effects on perceived stress and related mental health and well-being outcomes are examined as secondary outcomes.

Eligibility

Primary outcome measure(s)

• Recruitment rate (feasibility) — Through completion of enrollment and baseline assessment (T0), approximately Month 1
  Proportion of eligible staff who provide consent and enroll, calculated as the number enrolled divided by the number eligible, expressed as a percentage. A priori progression threshold is set at 70% or higher.
• Session attendance rate (feasibility) — Across the 5-week intervention period (Weeks 1 to 5)
  Proportion of intervention-arm participants attending at least 3 of the 5 SH+ sessions, expressed as a percentage. A priori threshold is 70% or higher.
• Follow-up completion / retention rate (feasibility) — From baseline (T0) to 3-month follow-up (T2)
  Proportion of enrolled participants completing the 3-month follow-up (T2) assessment, expressed as a percentage. A priori threshold is 75% or higher.
• Acceptability and participant satisfaction (feasibility) — At post-intervention (T1), approximately Week 5-6
  Participant-reported acceptability and satisfaction with the intervention, assessed using the purpose-built SH+ Programme Evaluation Form.

Trial sites (1)

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