Contextual Behavioral Science and Global Mental Health: Synergies and opportunities

Abstract

Global Mental Health (GMH) initiatives aim to address inequities in mental health care across the world. Particular emphasis is placed on building mental health service capacity in low- and middle-income countries (LMIC) where over 80% of the global population live. Consistent with this approach, concerted efforts are being made to globally disseminate psychological interventions. These initiatives must negotiate tensions that exist between making interventions sufficiently scalable, whilst retaining aspects of the psychotherapy process that maximize both the acceptability and efficacy of psychological interventions. This paper reflects on the important contribution that Contextual Behavioral Science (CBS) can make to GMH. CBS draws on behavioral and environmental principles that translate into various therapeutic applications [including Acceptance and Commitment Therapy (ACT) and Functional Analytic Psychotherapy (FAP)] and social change initiatives (such as the PROSOCIAL approach). Consideration will be given to the cross-cultural utility and validity of CBS approaches, and the way in these can help ensure that GMH initiatives extend beyond narrow efforts to address symptoms of mental disorders to include a focus on enhancing wellbeing. It is proposed that knowledge from ACT and FAP can help build sophistication in efforts to develop and deliver ‘therapist-free’ psychological interventions that will need to retain sensitivity to clients’ emotional expressions. In addition, the PROSOCIAL approach provides opportunities for groups of people to cooperate effectively to achieve shared aspirations and build ‘communities of support’ that can serve to optimize peoples’ mental health and wellbeing.