Effects of Mental Health Paraprofessional Training for Filipina Foreign Domestic Workers in Singapore
- 22 Downloads
Research has found that 24% of foreign domestic workers (FDWs) in Singapore have poor mental health (24%), with depressive symptoms being identified as the second most severe psychological symptoms . The study assessed the acceptability and effectiveness of a 4-week cognitive behavioral therapy (CBT)-based paraprofessional training program for FDWs in Singapore on depression literacy and CBT knowledge (primary outcomes), depression-related stigma, as well as attitudes towards seeking professional help (secondary outcomes) immediately and 2 months following the training. Forty female Filipino FDWs were recruited and randomized into either a CBT-based paraprofessional training program or wait-list (WL) group. Participants completed outcome measures before, after, and 2 months following their training. No significant difference was found on changes on any of the outcome variables in the intervention group as compared to the WL group. Following training, both groups showed significantly improved depression literacy, CBT knowledge, and attitudes towards seeking professional help. These changes were sustained at 2-month follow-up. All participants indicated a high level of satisfaction with the training program. While findings from between-group analyses do not support the efficacy of the CBT-based paraprofessional training program in improving depression literacy and related outcomes, participation in the program was associated with improvements in several outcomes within the training group. Future research should explore adaptations to the program (e.g., in terms of training duration and modes of delivery) that would increase its efficacy in improving depression literacy and CBT knowledge among FDWs.
KeywordsCognitive behavioral therapy Foreign domestic workers Paraprofessional training Depression Mental health
The authors would like to acknowledge the Humanitarian Organization for Migration Economics (HOME) for their collaboration and support of this study. The authors would also like to thank all participants for their involvement. The authors would also like to express their gratitude to Jolovan Wham (Executive Director of HOME), Suzhen Zhang, Pei Ling Tng, Young Ern Saw, and Ann-Marie Ng Ching Hui for contributing to various aspects of the study. The study was funded by a start-up Grant (R-581-000-153-133) awarded to Dr. Shian-Ling Keng by the Faculty of Arts and Social Sciences in National University of Singapore (NUS), as well as a master’s thesis grant awarded by Department of Psychology at NUS to Marian Wong.
Compliance with ethical standards
Conflict of interest
All authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were reviewed and in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
- 1.Humanitarian Organization for Migration Economics (HOME): Home sweet home? Work, life and well-being of foreign domestic workers in Singapore. Research report. Research Across Borders; Mar 2015; http://www.researchgate.net/profile/Anja_Wessels/publication/273260187_Home_sweet_home_Work_life_and_well-being_of_foreign_domestic_workers_in_Singapore_Research_report/links/54fd0e1f0cf20700c5ea0eac/Home-sweet-home-Work-life-and-well-being-of-foreign-domestic-workers-in-Singapore-Research-report.pdf.
- 2.Tan A: Stop hiring Indonesian maids directly. The Straits Times. 10 Fen 2013; http://www.asiaone.com/print/News/Latest%2BNews/Singapore/Story/A1Story20130206-400566.html.
- 3.Tan A: New rules for hiring Myanmar maids cover minimum monthly wage, day off. The Straits Times. 24 Mar 2014; http://www.straitstimes.com/singapore/new-rules-for-hiring-myanmar-maids-cover-minimum-monthly-wage-day-off.
- 4.Varia N: Maid to order: ending abuses against migrant domestic workers in Singapore. Human Rights Watch; Dec 2005; https://www.hrw.org/reports/2005/singapore1205/singapore1205wcover.pdf. Accessed 5 Aug 2015.
- 5.Sobritchea C: The sexual and reproductive health status and needs of Filipino female migrant domestic workers. In Manila, Philippines; 2008; https://www.researchgate.net/publication/239557786_The_Sexual_and_Reproductive_Health_Status_and_Needs_of_Filipino_Female_Migrant_Domestic_Workers1. Accessed 5 Aug 2015.
- 6.Wong A: Identifying work-related stressors and abuses and assessing their impact on the health of migrant domestic workers in Singapore. University of British Columbia; Nove 2010; https://static1.squarespace.com/static/5a12725612abd96b9c737354/t/5a1fe5ec24a694adca7f7596/1512039924080/Report_Identifying-Work-Related-Stressors-and-Abuses-and-Understanding-their-Impact-on-the-Health-and-Well-Being-of-Migrant-Domestic-Workers-in-Singapore.pdf.
- 7.Mahendran R, Aw S. Psychiatric illness in Filipino maids admitted to Woodbridge Hospital. Singap Med J. 1993;34(1):38–40.Google Scholar
- 12.National Institute for Health and Care Excellence (NICE): Depression in adults: recognition and management [Internet]. 2009; https://www.nice.org.uk/guidance/CG90.
- 23.Baranowski T, et al. How individuals, environments, and health behavior interact. In: Glanz K, Rimer BK, Lowis FM, editors. Health behavior and health education: Theory, research, and practice. 3rd ed. San Francisco: Jossey-Bass; 2002.Google Scholar
- 24.Buck PJ: Expanding mental health services delivery for depression in the community from Burma in North Carolina: A paraprofessional training program [Unpublished PhD thesis]. Duke University; 2015; https://dukespace.lib.duke.edu/dspace/bitstream/handle/10161/10539/Buck_duke_0066D_12530.pdf?sequence=1.
- 26.Fischer EH, Farina A. Attitudes toward seeking professional psychological help: A shortened form and considerations for research. J Coll Stud Dev. 1995;36(4):368–73.Google Scholar
- 29.Attkisson CC, Greenfield TK. The client satisfaction questionnaire (CSQ) scales. In: Sederer LL, Dickey B, editors. Outcome assessment in clinical practice. Baltimore, MD: Williams & Wilkins; 1995. p. 120–7.Google Scholar