Group-Based Cognitive Behavioral Therapy (CBT) Training Improves Mental Health of SME Entrepreneurs: Experimental Evidence from Conflict-Affected Areas of Pakistan

40 Pages Posted: 5 Aug 2019 Last revised: 7 Aug 2019

See all articles by Priyam Saraf

Priyam Saraf

World Bank

Tasmia Rahman

World Bank

Julian C. Jamison

University of Exeter Business School - Department of Economics; World Bank eMBeD (Mind, Behavior, and Development); Massachusetts Institute of Technology (MIT) - Abdul Latif Jameel Poverty Action Lab (J-PAL); Innovations for Poverty Action

Date Written: June 4, 2019

Abstract

Mental health, well-being, and lasting economic outcomes are intimately connected. However, in geographies marked by fragility, conflict, and violence (FCV), entrepreneurs of small and medium size enterprises (SMEs) experience chronic stress and poor mental health on a regular basis. These issues can hamper performance and quality of life for the entrepreneurs, and can dampen the benefits of existing financial and business assistance programs. Few proven rigorous interventions are known. This study tests the hypothesis that a five-week group Cognitive Behavioral Therapy (CBT) training called Problem Management Plus for Entrepreneurs (PM+E), in combination with financial assistance, could be more effective at reducing psychological stressors of SME entrepreneurs in FCV contexts than financial assistance alone. Meaningful and statistically significant improvements in mental health were achieved, with improvements persisting and increasing beyond the immediate post-intervention period. Based on analysis of pooled data across two follow-up rounds (at five weeks and three months post-intervention), entrepreneurs in the treatment group experienced statistically significant reduction in the intensity and prevalence of depression and anxiety symptoms (measured by the Patient Health Questionnaire Anxiety and Depression Scale) and higher levels of well-being (measured by the World Health Organization Well-Being Index) compared with the control group. The effect was marked for those experiencing mild/moderate levels of depression and anxiety, suggesting the clinical value of such low touch interventions. Overall, the study demonstrates that empirical research through Randomized Control Trials (RCTs) can be conducted in challenging, FCV settings through appropriate rapid training of local researchers and non-specialist providers (NSPs) at a low cost, yielding scalable programmatic and policy level lessons.

Keywords: Mental Health, Health Care Services Industry, Educational Sciences, Marketing, Private Sector Economics, Private Sector Development Law

Suggested Citation

Saraf, Priyam and Rahman, Tasmia and Jamison, Julian C., Group-Based Cognitive Behavioral Therapy (CBT) Training Improves Mental Health of SME Entrepreneurs: Experimental Evidence from Conflict-Affected Areas of Pakistan (June 4, 2019). World Bank Policy Research Working Paper No. 8872. Available at SSRN: https://ssrn.com/abstract=3430478

Priyam Saraf (Contact Author)

World Bank ( email )

1818 H Street, NW
Washington, DC 20433
United States

Tasmia Rahman

World Bank ( email )

1818 H Street, NW
Washington, DC 20433
United States

Julian C. Jamison

University of Exeter Business School - Department of Economics ( email )

Streatham Court
Exeter, EX4 4RJ
United Kingdom

World Bank eMBeD (Mind, Behavior, and Development) ( email )

1818 H Street, N.W.
Washington, DC 20433
United States

Massachusetts Institute of Technology (MIT) - Abdul Latif Jameel Poverty Action Lab (J-PAL) ( email )

30 Wadsworth Street, E53-320
77 Massachusetts Avenue
Cambridge, MA 02142
United States

Innovations for Poverty Action ( email )

1731 Connecticut Ave, 4th floor
New Haven, CT 20009
United States

Here is the Coronavirus
related research on SSRN

Paper statistics

Downloads
37
Abstract Views
167
PlumX Metrics