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Case Report

Problem-Solving and Behavioural Activation for Young Mothers with Depression in Harare, Zimbabwe: A Mixed-Methods Case Series

by
Concilia Tarisai Bere
1,*,
Rufaro Hamish Mushonga
1,
Rhulani Beji-Chauke
2,
Patrick Smith
2,
Jermaine Dambi
3,
Dzifa Abra Attah
4,
Takudzwa Mtisi
1,
Dixon Chibanda
3 and
Melanie Abas
2
1
Faculty of Medicine and Health Sciences, University of Zimbabwe, Mt. Pleasant, Harare P.O. Box MP 167, Zimbabwe
2
Institute of Psychiatry, Psychology and Neuroscience, Faculty of Social Science & Public Policy, Kings College London, London WC2R 2LS, UK
3
Friendship Bench, 4 Weal Road, Milton Park, Harare 0002, Zimbabwe
4
Department of Psychiatry, Medical School, University of Ghana, Legon, Accra P.O Box LG 25, Ghana
*
Author to whom correspondence should be addressed.
Epidemiologia 2025, 6(4), 72; https://doi.org/10.3390/epidemiologia6040072
Submission received: 7 August 2025 / Revised: 26 September 2025 / Accepted: 13 October 2025 / Published: 3 November 2025
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Abstract

Background. Depression and anxiety among young people in Africa are highly prevalent and a significant public health concern. Evidence-based interventions (EBIs) tailored to this demographic’s unique cultural and contextual needs are limited. Methods. We evaluated an intervention that integrates Behavioural Activation (BA) into Problem-Solving Therapy (PST), focusing on its acceptability, feasibility, preliminary impact on depression and anxiety, and necessary adaptations. Three participants with clinically elevated depression received the six-week intervention. Measures of depression (PHQ-9) and anxiety (GAD-7) were administered pre-intervention and at six subsequent time points. Results. PHQ-9 scores decreased from a baseline median score of 15 (Q1–Q3: 11–17) to a follow-up median score of 3 (Q1–Q3: 1–8). GAD-7 score decreased from a baseline median score of 12 (Q1–Q3: 5–14) to a median score of 6 (Q1–Q3: 1–8). Participants endorsed BA components, emphasizing social interaction and achievement-oriented activities, which were perceived as empowering and culturally resonant. Qualitative feedback highlighted the need for adaptations, including simplified language and localized examples, to enhance relevance. Conclusions. Findings support the feasibility of task-sharing BA-enhanced PST with lay workers, but point to the necessity of iterative cultural adaptation to address socioeconomic barriers.
Keywords: African Youth; depression; anxiety; behavioural activation; problem solving therapy; cultural; contextual adaptation; acceptability; feasibility African Youth; depression; anxiety; behavioural activation; problem solving therapy; cultural; contextual adaptation; acceptability; feasibility

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MDPI and ACS Style

Bere, C.T.; Mushonga, R.H.; Beji-Chauke, R.; Smith, P.; Dambi, J.; Attah, D.A.; Mtisi, T.; Chibanda, D.; Abas, M. Problem-Solving and Behavioural Activation for Young Mothers with Depression in Harare, Zimbabwe: A Mixed-Methods Case Series. Epidemiologia 2025, 6, 72. https://doi.org/10.3390/epidemiologia6040072

AMA Style

Bere CT, Mushonga RH, Beji-Chauke R, Smith P, Dambi J, Attah DA, Mtisi T, Chibanda D, Abas M. Problem-Solving and Behavioural Activation for Young Mothers with Depression in Harare, Zimbabwe: A Mixed-Methods Case Series. Epidemiologia. 2025; 6(4):72. https://doi.org/10.3390/epidemiologia6040072

Chicago/Turabian Style

Bere, Concilia Tarisai, Rufaro Hamish Mushonga, Rhulani Beji-Chauke, Patrick Smith, Jermaine Dambi, Dzifa Abra Attah, Takudzwa Mtisi, Dixon Chibanda, and Melanie Abas. 2025. "Problem-Solving and Behavioural Activation for Young Mothers with Depression in Harare, Zimbabwe: A Mixed-Methods Case Series" Epidemiologia 6, no. 4: 72. https://doi.org/10.3390/epidemiologia6040072

APA Style

Bere, C. T., Mushonga, R. H., Beji-Chauke, R., Smith, P., Dambi, J., Attah, D. A., Mtisi, T., Chibanda, D., & Abas, M. (2025). Problem-Solving and Behavioural Activation for Young Mothers with Depression in Harare, Zimbabwe: A Mixed-Methods Case Series. Epidemiologia, 6(4), 72. https://doi.org/10.3390/epidemiologia6040072

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