Distillation and element-based design of psychological treatments in global mental health - a commentary on Brown et al

This commentary reflects on the "elements" approach in psychological treatment research, and its specific application to a systematic review of psychosocial interventions for youth in conflict-affected areas. We discuss three key questions for the field. First, what psychological treatment elements are necessary and/or sufficient to achieve clinically significant change for a given population? Second, how should elements be sequenced to achieve optimal outcomes? Third, what might account for the large heterogeneity observed in psychological treatment trials, other than the constituent practice elements? We conclude by describing a new research programme that aims to develop a transdiagnostic intervention targeting common mental health difficulties among school-going adolescents in India. The initial experience of this programme affirms the utility of aligning an elements approach with contextually-sensitive formative research.