Systematic Review 2026-04-21 posted v1

Evaluating the Effectiveness of WHO Self-Help Plus (SH+): A Scoping Review of Populations, Adaptations, and Outcomes

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Dr Farah Rashid National University of Sciences and Technology, Islamabad. Pakistan
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2. Dr. Mehreen Nasir Services Institute of Medical Sciences, Lahore, Pakistan
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Dr Shaza Shahid Intern Aga Khan University. Karachi. Pakistan
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Dr Afshan Shahid Services Institute of Medical Sciences, Lahore, Pakistan
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Dr Abid Malik Professor and HOD Public Mental Health
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Dr Atif Rahman Professor of Child Psychiatry & Global Mental Health, Department of Primary Care and Mental Health Institute of Population Liverpool L69 3BX, United Kingdom

Abstract

Purpose This study aims to describe the evidence on effectiveness of Self-Help Plus (SH+) intervention including targeted populations, adaptations made, mode of delivery, outcomes and barriers. Methods A scoping review was conducted following the Arksey and O’Malley framework. Four electronic databases (PubMed, APA PsycINFO, DOAJ, and Google Scholar) were searched for peer-reviewed studies published between 2016 and January 2026 using the keywords “Self Help Plus” and “intervention”. Grey literature was excluded. Two reviewers screened studies and tabulated data independently on the characteristics of the studies, mode of delivery, adaptations, outcomes and obstacles to implementation. Results Out of 83 potential records identified, 17 studies met the inclusion criteria. Approximately 60% of the studies included were conducted in low- and middle-income countries. Half of the studies (52.9%) were conducted on refugees and asylum seekers. Effectiveness studies showed that SH+ can reduce psychological distress, depression, anxiety, and post-traumatic stress symptoms, and improve wellbeing, functioning, and psychological skills, with some variability depending on trauma exposure and adherence. Reported implementation barriers included logistical constraints, literacy and comprehension issues, funding challenges, and the need for booster sessions. Conclusion Self-Help Plus (SH+) is a feasible and acceptable low-intensity psychological approach that can enhance mental wellbeing and coping skills in diverse populations. Effectiveness may be influenced by trauma exposure, adherence, and implementation barriers such as logistics, literacy, technology, and funding need to be addressed.

Citation Information

@article{drfarahrashid2026,
  title={Evaluating the Effectiveness of WHO Self-Help Plus (SH+): A Scoping Review of Populations, Adaptations, and Outcomes},
  author={Dr Farah Rashid and 2.	Dr. Mehreen Nasir and Dr Shaza Shahid and Dr Afshan Shahid and Dr Abid Malik and Dr Atif Rahman},
  journal={Research Square},
  year={2026},
  doi={https://doi.org/10.21203/rs.3.rs-9461113/v1}
}
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