Eva Heim

University of Lausanne | UNIL ·  Institut de psychologie (IP)

Background Loss and grief pose significant challenges for victims of armed conflicts, such as Syrian refugees. Internet-based interventions (IBIs) present a promising solution to address this treatment gap and provide adequate support. However, research on grief, grief support, and IBIs remain largely limited to Western cultural contexts, and cultu...

Purpose: This qualitative study explores how cultural factors influence the perception of aging, older people, and traumatic experiences in the Yenish community in Switzerland. The Yenish are an ethnic minority with a traveling lifestyle who were targeted by a Swiss governmental youth care foundation scheme called "Kinder der Landstrasse” (Children...

Background Digital mental health interventions for smartphones, such as the World Health Organization (WHO) Step-by-Step (SbS) program, are potentially scalable solutions to improve access to mental health and psychosocial support in refugee populations. Our study objective was to evaluate the effectiveness of SbS as self-guided intervention with o...

Background: Loss and grief pose significant challenges for victims of armed conflicts, such as Syrian refugees. Internet-based interventions (IBIs) present a promising solution to address this treatment gap and provide adequate support. However, research on grief, grief support, and IBIs remain largely limited to Western cultural contexts and cultu...

Background Research on cultural adaptation of psychological interventions indicates that a higher level of adaptation is associated with a higher effect size of the intervention. However, direct comparisons of different levels of adaptations are scarce. Aims This study used a smartphone-based self-help programme called Step-by-Step (Albanian: Hap-...

Background An online self-help programme for the treatment of depression called Hap-pas-Hapi was tested among Albanian-speaking immigrants in Switzerland and Germany, and two different levels of cultural adaptation were compared. Despite a massive recruitment effort, an insufficient number of participants could be recruited, and the drop-out rate w...

Objectives Existing research recognizes the critical role that social, sociodemographic, and acculturative processes play in increasing vulnerability for experiencing psychological distress among second-generation migrants. However, to date, far too little attention has been given to the study of psychological distress in this social group. The mai...

Background Loneliness is a widespread phenomenon associated with a number of negative health outcomes. Older individuals may constitute one important target group with a need for effective interventions. However, despite evidence showing that addressing maladaptive social cognition (e.g., via cognitive behavioral therapy [CBT]) is the most effectiv...

Introduction Digital interventions are increasingly regarded as a potential solution for the inaccessibility of mental health treatment across low-and-middle-income settings, especially for common mental disorders. Step-by-Step (SbS) is a digital, guided self-help intervention for depression found effective in two Randomized Controlled Trials (RCTs...

BACKGROUND There is evidence from meta-analyses and systematic reviews that digital mental health interventions for depression, anxiety and stress-related disorders tend to be cost-effective. However, no such evidence exists for guided digital mental healthcare in low and middle-income countries facing humanitarian crises, where needs are highest....

Background There is evidence from meta-analyses and systematic reviews that digital mental health interventions for depression, anxiety, and stress-related disorders tend to be cost-effective. However, no such evidence exists for guided digital mental health care in low and middle-income countries (LMICs) facing humanitarian crises, where the needs...

Background Lebanon is a low-to-middle-income country, hosting more than 1.1 million Syrian refugees, with 90% mental health treatment gap. The National Mental Health Programme (NMHP) in Lebanon along with the World Health Organization (WHO) launched the Step-by-Step (SbS) e-mental health intervention for adults with depression. Step-by-Step is a 5-...

Background: Loneliness is a widespread phenomenon associated with a number of negative health outcomes. Older individuals may constitute one important target group with a need for effective interventions. However, despite evidence showing that addressing maladaptive social cognition (e.g., via cognitive behavioral therapy [CBT]) is the most effecti...

Numerous studies have been conducted among survivors of the genocide against the Tutsi on the prevalence of depression and post-traumatic stress disorder. However, thus far, no studies provide information on the frequency of comorbidity of these disorders, the prevalence of the new trauma-related diagnostic disorder known as complex post-traumatic...

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A scoping review was conducted to explore the metaphors and related expressions older adults use to describe extremely stressful events that may lead to Post-Traumatic Stress Disorder (PTSD), Complex PTSD (CPTSD), Prolonged Grief Disorder (PGD), or Adjustment Disorder (AjD). Relevant databases from psychology, gerontology, and related fields were s...

Child maltreatment has been linked to insecure adult attachment. However, it is not yet clear how different child maltreatment types are associated with attachment-related anxiety and avoidance in adulthood; and whether resilience against these insecure attachment styles is dependent on risk-specific resources. Therefore, this study explored differ...

Objectives Small area analysis is a health services research technique that facilitates geographical comparison of services supply and utilization rates between health service areas (HSAs). HSAs are functionally relevant regions around medical facilities within which most residents undergo treatment. We aimed to identify HSAs for psychiatric outpat...

Background People with mental illnesses are at an increased risk of experiencing human rights violations, stigma and discrimination. Even though mental health stigma and discrimination are universal, there appears to be a higher burden in low- and middle-income countries. Anti-stigma interventions need to be grounded in local evidence. The aim of t...

Background Most displaced people with mental disorders in low- and middle-income countries do not receive effective care, and their access to care has deteriorated during the Coronavirus Disease 2019 (COVID-19) pandemic. Digital mental health interventions are scalable when digital access is adequate, and they can be safely delivered during the COV...

Background: Most people with mental disorders in communities exposed to adversity in low-income and middle-income countries (LMICs) do not receive effective care. Digital mental health interventions are scalable when digital access is adequate, and can be safely delivered during the COVID-19 pandemic. Objective: To examine the effects of a new W...

Background Mental health-related stigma is a global public health concern and a major barrier to seeking care. In this study, we explored the role of stigma as a barrier to scaling up mental health services in primary health care (PHC) centres in Lebanon. We focused on the experiences of Healthcare Providers (HCPs) providing services to patients wi...

There is a lack of empirical research on the heterogeneity in well‐being of individuals who disaffiliated (i.e., left or were expelled) from an exclusionary and demanding faith community. Thus, little quantitative knowledge exists on factors related to resilience in these individuals. Therefore, the study aims were twofold: (1) to identify profiles...

Complex post-traumatic stress disorder (CPTSD) was introduced as a new diagnostic category in ICD-11. It encompasses PTSD symptoms along with disturbances in selforganisation (DSO), i.e., affect dysregulation, negative self-concept, and disturbances in relationships. Quantitative research supports the validity of CPTSD across different cultural gro...

Background Although a high proportion of older adults suffer from common mental disorder symptoms and psychosocial problems, only a small number of older individuals seek psychological treatment. Internet-based interventions have the potential to bridge this treatment gap. However, while there is extensive literature on internet-based treatments in...

Aims Stigma related to mental disorders is a barrier to quality mental healthcare. This scoping review aimed to synthesise literature on stigma related to mental disorders in Nepal to understand stigma processes. The anthropological concept of ‘what matters most’ to understand culture and stigma was used to frame the literature on explanatory model...

Background There is a lack of empirical evidence on the level of cultural adaptation required for psychological interventions developed in Western, Educated, Industrialized, Rich, and Democratic (WEIRD) societies to be effective for the treatment of common mental disorders among culturally and ethnically diverse groups. This lack of evidence is par...

Background Refugees and asylum seekers in Europe are affected by high prevalence of common mental disorders. Under the call ‘mental health of refugee populations’, the German Federal Ministry of Education and Research (FMER) funded a series of research projects to test evidence-based psychological interventions among refugee populations in Germany....

Background: This study aims to provide a transparent and replicable documentation approach for the cultural adaptation of a cognitive-behavioural transdiagnostic intervention (Common Elements Treatment Approach, CETA) for Arabic-speaking refugees with common mental disorders in Germany. Method: A mixed-methods approach was used, including litera...

Background Stigma is a barrier for help-seeking, mental health service access, and contributes to the mental health treatment gap. Because the mental health treatment gap is greatest in low- and middle-income countries, it is vital to identify effective strategies to reduce stigma in these settings. To date, there has been a lack of synthesis of fi...

Background Stigma among healthcare providers is a barrier to the effective delivery of mental health services in primary care. Few studies have been conducted in primary care settings comparing the attitudes of healthcare providers and experiences of people with mental illness who are service users in those facilities. Such research is necessary ac...

Background Mental health related stigma is a global public health concern and is considered a major barrier to seeking care. In this study, we explored the role of stigma as a barrier to scaling up mental health services in primary health care (PHC) centres in Lebanon. We focused on the experiences of PHC workers, while providing services to patien...

Background People with mental illnesses are at an increased risk of experiencing human rights violations, stigma and discrimination. Even though mental health stigma and discrimination are universal, there appears to be a higher burden in low- and middle-income countries. Anti-stigma interventions need to be grounded in local evidence. The aim of t...

Background E-mental health interventions may help to bridge the mental health treatment gap. Evidence on their effectiveness is compelling in high-income countries. Not enough evidence has been generated on their use with communities affected by adversity in low- and middle-income countries. The World Health Organization (WHO), the National Mental...

Background: In order to narrow the world-wide treatment gap, innovative interventions are needed that can be used among culturally diverse groups, e.g., immigrant populations in high-income countries. Research on cultural adaptation of psychological interventions indicates that a higher level of adaptation is associated with a higher effect size of...

Background Internet- and mobile-based mental health interventions have the potential to narrow the treatment gap in ethnic groups. Little evidence exists on the cultural adaptation of such interventions. Cultural adaptation of evidence-based interventions distinguishes between surface and deep structure adaptation. Surface refers to matching materi...

BACKGROUND The lack of availability of evidence-based services for people exposed to adversity globally has led to the development of psychological interventions with features that will likely make them more scalable. The evidence for the efficacy of e-mental health from high-income countries is compelling and the use of these interventions could b...

Background The lack of availability of evidence-based services for people exposed to adversity globally has led to the development of psychological interventions with features that will likely make them more scalable. The evidence for the efficacy of e-mental health from high-income countries is compelling, and the use of these interventions could...

The concept of psychological trauma implies that people experiencing traumatic stress are wounded, thus relating to the metaphor of a physical injury. Although this notion is widely accepted by clinicians and researchers in mental health, there is evidence of a broad range of metaphorical idioms for extremely aversive experiences or catastrophic ev...

Cultural variability regarding concepts of distress for common mental disorders (CMD) has been reported extensively in cultural clinical psychology across the globe. However, little is known about illness narratives in social communities from Southeast Europe. The purpose of this paper is to identify cultural concepts of distress (CCDs) among Alban...

Background E-mental health is an established mode of delivering treatment for common mental disorders in many high income countries. However, evidence of its effectiveness in lower income countries is lacking. This mixed methods study presents lessons learned and preliminary data on the feasibility of a minimally guided e-mental health intervention...

The worldwide mental health treatment gap calls for scaling-up psychological interventions, which requires effective implementation in diverse cultural settings. Evidence from the field of global mental health and cultural clinical psychology indicates cultural variation in how symptoms of common mental disorders are expressed, and how culturally d...

Adversity-related metaphors Sometimes we feel imprisoned [tied], with tied hands, without being able to do anything. As vezes a gente se sente amarrados. De mãos atadas, sem ter como agir. This was the moment we felt blocked. E aí foi quando bloqueou. We are branded, marked. Nos somos marcados. Feeling empty Senir-se vazio Live this constant fight...

The expressions resilience and posttraumatic growth represent metaphorical concepts that are typically found in Euro-American contexts. Metaphors of severe adversity or trauma and the expressions of overcoming it vary across cultures—a lacuna, which has not been given much attention in the literature so far. This study aimed to explore the metaphor...

Reducing mental health-related stigma in primary health care settings in low- and middle-income countries: a systematic review – CORRIGENDUM - E. Heim, B. A. Kohrt, M. Koschorke, M. Milenova, G. Thornicroft

Aims This systematic review compiled evidence on interventions to reduce mental health-related stigma among medical and nursing students in low- and middle-income countries (LMICs). Primary outcomes were stigmatising attitudes and discriminatory behaviours. Methods Data collection included two strategies. First, previous systematic reviews were se...

Cross-national epidemiological studies show that prevalence rates of common mental disorders (i.e. depression, anxiety disorders, and PTSD) vary considerably between countries, suggesting cultural differences. In order to gather evidence on how culture relates to the aetiology and phenomenology of mental disorders, finding meaningful empirical inst...

This edited volume outlines approaches to cultural clinical psychology in three broad areas: (1) culturally sensitive approaches to PTSD and related mental disorders; (2) cultural values, metaphors, and the search for universals; and (3) global mental health and intervention challenges. In addition to mapping key issues for research, the volume aim...

Introduction: The aim of this study is to describe the initial stages of the iterative and user-centered mobile mental health adaptation process of Step-by-Step (SbS), a modularized and originally web-based e-mental health intervention developed by the World Health Organization (WHO). Given the great need for improving the responsiveness and access...

E-Mental-Health-Angebote haben großes Potenzial, um Menschen in unterversorgten Gebieten mit niederschwelligen psychotherapeutischen Angeboten zu erreichen, insbesondere Geflüchtete. Solche Ansätze werden in verschiedenen Ländern getestet. Therapeutische Interventionen wie Verhaltensaktivierung oder Entspannungstechniken eignen sich gut und können...

Background Lebanon has a need for innovative approaches to increase access to mental health care to meet the country's current high demand. E-mental health has been included in its national mental health strategy while in parallel the World Health Organization has produced an online intervention called ‘Step-by-Step’ to treat symptoms of depression...

Background: Insomnia has become a major public health concern. Aims: The study examined the efficacy of a web-based unguided self-help programme with automated feedback. The programme was based on cognitive behaviour therapy for insomnia (CBT-I). The investigation particularly focused on factors that contribute to the maintenance of insomnia and...

Aims This systematic review compiled evidence on interventions to reduce mental health-related stigma in primary health care (PHC) in low- and middle-income countries (LMICs). Studies targeting PHC staff (including non-professionals) were included. Primary outcomes were stigmatising attitudes and discriminatory behaviours. Methods Data collection...

The World Health Organization is developing a range of interventions, including technology supported interventions, to help address the mental health treatment gap, particularly in low and middle-income countries. One of these, Step-by-Step, is a guided, technology supported, intervention for depression. It provides psychoeducation and training in...

The metaphorical concepts resilience and post-traumatic growth (PTG) reflect the contemporary Western understanding of overcoming highly challenging life events. However, it is known that across different cultures, a broad range of metaphorical idioms for describing adaptive responses to severe adversity exists. This study aimed to explore and cont...

Zusammenfassung Depressivität und andere psychische Erkrankungen sind eine häufige Begleiterscheinung militärischer Auslandseinsätze. Ein neueres Forschungsfeld befasst sich mit persönlichen Wert­orientierungen und moralischen Verletzungen und deren Rolle bei der Entstehung psychischer Einsatzfolgen. In der vorliegenden Studie wurden Bundeswehrsold...

Objective: To examine the working alliance between users and an avatar and users' treatment expectations in an unguided Internet intervention for the treatment of insomnia. Methods: The sample included participants from the treatment condition (N = 29) of a randomised controlled trial. The task and goal subscales of the Working Alliance Inventory S...

This study examined Bolivian women’s decisions to stay with or leave their violent partners. The theory of planned behavior (TPB) was used as the theoretical framework. One hundred thirty-four women were assessed 3 times over 6 months. The TPB constructs were measured at T1 and T2; relationship status was assessed at T3. At T2, attitudes about stay...

Dieses Dokument wurde von der FSP Arbeitsgruppe Onlineinterventionen, zusammen mit Expertinnen und Experten aus Wissenschaft, psychotherapeutischer Praxis und Beratung, erstellt. Die Arbeit der Gruppe knüpft an die Vorarbeiten der Jahre 2003 und 2006 an, als erste Qualitätskriterien erarbeitet wurden. Ziel dieses Dokuments ist es, Qualitätsstandard...

Die folgenden Qualitätsstandards für Fachpersonen Beratung sollten von Psychologinnen und Psychologen, die Onlineinterventionen anbieten und durchführen, eingehalten werden. Dieses Dokument wurde von der FSP Arbeitsgruppe Onlineinterventionen, zusammen mit Expertinnen und Experten aus Wissenschaft, psychotherapeutischer Praxis und Beratung, erstell...

Psychologists and psychiatrists providing online interventions must present and apply the following quality standards. This document has been compiled with the FSP working group for online interventions in collaboration with academic experts and experts in psychotherapy and psychotherapeutic counselling. The work this group has been carrying out dr...

Rationale: The prevalence of common mental disorders (CMDs, i.e., depression and anxiety) worldwide is substantial, and prevalence rates are higher in high-income than in low- and middle-income countries. This difference might reflect both underlying prevalence rates as well as the measurement model used in cross-national epidemiological studies....

The present study examined Chinese students’ personal value orientations according to the Schwartz value theory in comparison with students from Germany and Russia. The theory postulates 10 value orientations grouped into four higher-order factors: conservation versus openness to change and self-transcendence versus self-enhancement. Schwartz’ valu...

Die stetig wachsende kulturelle Diversität und die weltweite Versorgungslücke im Bereich psychischer Gesundheit haben zu einem „Globalisierungs“-Anspruch an die Psychotherapie geführt, weshalb die kulturelle Anpassung von evidenzbasierten Diagnose- und Interventionsverfahren zunehmend an Bedeutung gewinnt. Dieser Beitrag stellt aktuelle Forschungse...

Das klassische Konzept der „sozialen Unterstützung“ wird im Zusammenhang mit traumatisierten Patientengruppen und hier aktuell den traumatisierten Flüchtlingen und Migranten wieder besonders aktuell. Der Beitrag soll wichtige Ergebnisse der Soziale-Unterstützungs-Forsch