We discovered The Friendship Bench from Zimbabwe recently and we LOVE it. We’ve been thinking on mental health, resilience and well-being for some time (and even having it has our topic of the month in December 2020) and this fits in perfectly.
The mission of the Friendship Bench is to create safe spaces and a sense of belonging in communities, to enhance mental wellbeing and improve people’s’ quality of life. Guided by our values of empathy and connection, and anchored in over a decade of rigorous research we have re-imagined the delivery of evidence-based mental healthcare.
The Friendship Bench clinical team trains community health workers (also known as lay health workers) to provide basic Cognitive Behavioural Therapy with an emphasis on Problem Solving Therapy, activity scheduling and peer led group support. This task shifting approach means we can deliver an effective, affordable and sustainable solution to bridge the mental health treatment gap at a primary care level.
We deliver the talk therapy intervention to people with mild to moderate level common mental health disorders, such as anxiety and depression, known locally as ‘kufungisisa’- thinking too much. When people visit the Friendship Bench they are screened with a locally validated tool called the Shona Symptom Questionnaire (SSQ-14). If a person scores above the cut off point, they are suggested to stay and receive the one-on-one problem solving therapy. In practical terms, participants are taught a structured approach to identifying problems and find workable solutions.
We are not conventional, our trained CHWs sit with their clients outdoors, under the trees on wooden park benches in discreet safe spaces in the community. During training, a referral pathway is established for cases which are considered ‘red flags’ where a higher level of care is needed.
After the one-on-one talk therapy, Friendship Bench clients are introduced to a peer led support group known as Circle Kubatana Tose (CKT), meaning ‘holding hands together’. In these groups clients are connected to others who have sat on the Friendship Bench, received PST and became empowered to solve their own problems. Group members can relate to one another because they tend to come from the same community and have learned about the benefit of empathic listening. This safe space to talk in and be heard contributes to clients’ sense of belonging and reduces stigma surrounding mental health and sharing of personal issues.
In the CKT groups, clients are engaged in revenue generating opportunities, learning to crochet items out of recycled plastic bags and old VHS tape ribbon! Some items commonly made and then sold in the community are bags, hats and mats. So beyond the group being a form of ongoing support and behavioural activation, it becomes a vital part of the intervention due to the need for income generation in a country going through socio-economic distress.
Due to Covid-19, the benches are operating a little differently, but they’re still there to help online and via downloads. We have a great storybook, Unlocked!, about coping during the pandemic that would support conversations with children and adolescents, download it for free now!