In the current mental health care context, there is a call for inter-professional collaborative relationships and practices to embrace the active participation of service users and their primary communities.
“The manner of engagement – the way we develop a relationship with another person – influences the kind and quality of conversations that we can have with each other, and likewise the conversations we begin to have with each other will influence the kind and quality of our relationships.” (SOURCE: Collaborative Practice: A Way of Being “With”)
The Friendship Bench Model
The Friendship Bench (FB) is an evidence-based psychological intervention for common mental disorders (CMD) such as depression and anxiety (Chibanda, Verhey, Munetsi, Rusakaniko, et al., 2016; Chibanda, Weiss, et al., 2016). It originated in Zimbabwe and has been replicated and scaled up in several countries. The FB program is delivered by lay community health workers on wooden park benches. The benches are located in primary health clinics (PHC) and therefore easily accessed. The non-specialist community health workers are trained in the Friendship Bench model which offers a problem-solving therapy (PST) approach based on cognitive behavioural therapy (CBT) principles. The FB consists of a two-pronged strategy offering individual counselling and a group support with an incoming generating component.
FB successfully uses task-shifting to narrow the treatment gap for mental, neurological and substance use disorders which are a global epidemic particularly in low- and middle-income countries (LMIC).
Our peer reviewed publications highlight FB’s theoretical foundation as well as the evidence-base of the approach (Abas et al., 2016; Chibanda, 2017; Chibanda et al., 2017; Chibanda, Verhey, Munetsi, Cowan, & Lund, 2016; Verhey et al., 2019).
Implementation, the 5 Phase Package
Contrary to some beliefs the Friendship Bench is much more than a person gathering some friends, putting a bench in a park and inviting people to sit and chat about problems.
The Friendship Bench has been developed over a 25 year period from extensive community research. The package has been designed by psychiatrists, psychologists, professors, project-coordinators, research assistants, the community health workers themselves and other key personnel such as ministry of health and implementation partners.
The package we offer includes a situational analysis, followed by a Theory of Change workshop with all stakeholders, training of trainers, establishment of support systems, data collection systems and ongoing technical support. These 5 phases are laid out in a simplified chart below, within each phase exists various stages which get worked in collaboration with possible partners.
Simplified Flow Chart of Implementation
So, where can you start the process? Start here.
Pre-phase, Mini Suitability
If you would like to collaborate with the Friendship Bench, please download and complete our Mini Suitability Check below.
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by the Friendship Bench Trust.
• We do not give out our training material but rather explore ways of collaborating with organisations to implement the Friendship Bench to ensure a high level of fidelity to the program
• We aim to work within an already existing system for suitability reasons
• We specialise in Problem Solving Therapy (incl. psycho-education, awareness and teaching of emotional regulation skills), focusing on common mental disorders (depression, anxiety) in individual contact with a community health worker
• We use a training of trainers programme