CC BY-ND 4.0 Attribution-NoDerivatives 4.0 InternationalBah, Abdulai JawoWurie, Haja RamatulaiSamai, MohamedHorn, RebeccaAger, Alastair2025-02-242025-02-242025-02-03Bah, A.J., Wurie, H.R., Samai, M., Horn, R. and Ager, A. (2025) ‘Feasibility, acceptability and preliminary effectiveness of a culturally adapted nonspecialist delivery Problem-Solving Therapy: Friendship Bench Intervention for perinatal psychological distress in Sierra Leone’, Cambridge Prisms: Global Mental Health, 12, p. e16. Available at: https://doi.org/10.1017/gmh.2025.6.2054-4251https://eresearch.qmu.ac.uk/handle/20.500.12289/14169https://doi.org/10.1017/gmh.2025.6Abdulai Jawo Bah - ORCID: 0000-0002-3334-7882 https://orcid.org/0000-0002-3334-7882Alastair Ager - ORCID: 0000-0002-9474-3563 https://orcid.org/0000-0002-9474-3563In low- and middle-income countries like Sierra Leone, there is a significant gap in the treatment of perinatal mental health disorders such as anxiety, depression and somatization. This study explored the feasibility, acceptability and preliminary effectiveness of a culturally adapted Problem-Solving Therapy - Friendship Bench Intervention (PST-FBI) delivered by nonspecialists, mother-to-mother support groups (MMSGs), to perinatal women experiencing psychological distress. MMSGs provide 4 weeks of home-based, individual PST-FBI, followed by a peer-led group session called col at sacul (circle of serenity). The intervention targeted peri-urban pregnant women and new mothers screened for psychological distress. This was a two-armed, pre-post, waitlist-controlled study that employed the Sierra Leone Perinatal Psychological Distress Scale (SLPPDS) to screen and measure their outcomes. Feasibility and acceptability were examined through in-depth interviews using the Consolidated Framework for Implementation Research, analyzed thematically, while preliminary effectiveness was evaluated with chi-squared analysis for categorical and t-test for continuous variables. Twenty of the 25 women completed all four PST-FBI sessions delivered by five MMSGs. The individual PST and the peer-led session were viewed as beneficial for problem-sharing and skill building. The SLPPDS scores significantly dropped by 58.9% (17.1-8.4) in the intervention group, while the control group showed a 31.6% (18.0-12.3) decrease. The intervention's effect size was d = 0.40 (p < 0.05). The MMSG-led PST-FBI, including the col at sacul session, proved feasible, acceptable and with preliminary effectiveness in improving the mental health of peri-urban pregnant women and new mothers in Sierra Leone. Further randomized-controlled trials are recommended before nationwide implementation. © Queen Margaret University, 2025.e16en© Queen Margaret University, 2025. Published by Cambridge University Press. This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NoDerivatives licence (http://creativecommons.org/licenses/by-nd/4.0), which permits re-use, distribution, and reproduction in any medium, provided that no alterations are made and the original article is properly cited.http://creativecommons.org/licenses/by-nd/4.0/Mother-mother Support GroupsProblem-solving TherapyTask-sharingperinatal psychological distress and Friendship Bench InterventionArticle