Individual Self-Help Plus (SH+) for women earthquake survivors: Pilot randomized controlled trial

This pilot randomized controlled trial was conducted in Hatay province, Türkiye, targeting women aged 18-65 living in container cities after the February 2023 earthquakes. The sample included women aged 18 to 65 who met the inclusion criteria: direct exposure to the earthquake, elevated psychological distress (Kessler Psychological Distress Scale, K10 >15), and impaired psychosocial functioning (WHO Disability Assessment Schedule 2.0, WHODAS 2.0 >16). Participants were randomly assigned to either the SH+ intervention group or a control group by an independent researcher to ensure allocation concealment and minimize selection bias. The final analysis was conducted on completers only, comprising 23 participants in the SH+ group and 14 participants in the control group. A series of repeated measures MANOVA and post hoc pairwise analyses were conducted to evaluate changes from pre- to post-intervention. Within the SH+ group, participants demonstrated statistically significant reductions in depressive symptoms, anxiety, post-traumatic stress, and prolonged grief, indicating that the adapted SH+ intervention had a meaningful impact on key psychological symptoms. Furthermore, post-assessment comparisons between the intervention and control groups revealed significantly greater improvements in depressive symptoms, anxiety, and post-traumatic stress among those who received SH+. The significant improvements observed in participants receiving the SH+ intervention underline the importance of involving the target population in the development and adaptation of mental health programs. By engaging survivors as partners, the intervention was better positioned to address the complexities of trauma recovery in a way that respects local values and experiences. The study provides preliminary evidence that the individually delivered SH+ intervention is feasible and acceptable in a post-disaster setting. Preliminary evidence suggests it effectively reduces key psychological symptoms, making it a promising approach to support mental health and resilience among women earthquake survivors in Türkiye.