Lay-led group therapy reduces teen perinatal depression
Lay health workers delivering group interpersonal psychotherapy sharply reduced depressive symptoms in pregnant adolescents, with the longer program showing more sustained benefit.
*Pilot randomized clinical trial; Level 1b (OCEBM).

Citation

Kumar M, Tele A, Nyongesa V, et al. Group interpersonal psychotherapy for depression in perinatal adolescents in Kenya: a pilot randomized clinical trial. JAMA Network Open. 2026;9(6):e2618255. doi:10.1001/jamanetworkopen.2026.18255.

Background

Pregnant and parenting adolescents in low-resource settings often have depression but limited access to mental health specialists. This study tested whether a culturally adapted group psychotherapy could be delivered by non-specialists in primary care, and whether a shorter version works.

Patients

122 pregnant adolescents (ages 13-18) in the first to second trimester in Nairobi, Kenya, with significant depressive symptoms. Excluded: recent suicide plan/attempt, active substance misuse, severe cognitive/physical impairment, or severe mental illness.

Intervention

Group interpersonal psychotherapy delivered by community health promoters: either 8 weekly 90-minute sessions (full) or 4 weekly 90-minute sessions (mini), plus one individual pre-group session.

Control

Usual care: information sheets and routine follow-up calls.

Outcome

Depression symptoms (9-item Patient Health Questionnaire; range 0-27) and functional impairment (range 0-9). Secondary outcomes included distress and post-trauma symptoms.

Follow-up Period

Within 1 week after program completion; and 6 months.

Results

Significant outcomes Full program vs usual care Mini program vs usual care
Depression score, 1 week after completion (primary) Mean difference −5.79 (95% CI, −7.67 to −3.91) Mean difference −3.97 (95% CI, −5.83 to −2.10)
Depression score, 6 months (primary) Mean difference −2.22 (95% CI, −4.25 to −0.18) NS
Overall distress, 1 week after completion Mean difference −3.31 (95% CI, −6.17 to −0.45) NS
Post-trauma symptoms, 1 week after completion NS Mean difference 5.04 (95% CI, 0.95 to 9.13)
Well-being, 6 months NS Mean difference 12.48 (95% CI, 0.79 to 24.18)
NS = not statistically significant.
Analyses were intention-to-treat. Functional impairment did not differ between groups.

Limitations

Pilot size limits certainty and generalizability. End-of-treatment assessments occurred at different times (4 vs 8 weeks), complicating direct comparison. Attrition at 6 months may bias results. Outcomes were self-reported.

Funding

Fogarty International Center, US National Institutes of Health (K43TW010716); no funder role.

Clinical Application

In similar clinics, consider brief or full group interpersonal psychotherapy delivered by trained lay workers; use the full program when sustained symptom improvement is a priority.