Table 1.

Summary of World Health Organization mhGAP guidelines for management of conditions related to stress

Condition	Intervention	Client	Recommendation
Acute stress symptoms	Psychological	Adults	CBT-T recommended. No recommendation for EMDR, “stand-alone” problem-solving counseling, or psychoeducation. Stress management may be used if CBT not available along with PFA.
		Children	No specific recommendationa. PFA may be considered.
	Pharmacological	Adults	Benzodiazepines and antidepressants should not be offered.
		Children	Benzodiazepines and antidepressants should not be offered.
Secondary acute insomnia	Psychological	Adults	Relaxation technique and sleep hygiene advice should be provided through existing cultural practices recommended.
		Children	No specific recommendationa. Relaxation techniques and sleep hygiene advice may be safe and effective in adolescents.
	Pharmacological	Adults	Benzodiazepines should not be offered apart from exceptional cases in which short-term use (3–7) days may be considered.
		Children	Benzodiazepines and antidepressants should not be offered.
Secondary nonorganic enuresis	Psychological	Children	Psychoeducation and skills training for parents recommended.
Dissociative disorders	Psychological	Adults	No specific recommendationa. PFA and the use of culturally appropriate interventions that are not harmful may be considered.
		Children
Hyperventilation	Psychological	Adults	No specific recommendation for rebreathing into a paper baga.
		Children	Rebreathing into paper bag should not be considered.
PTSD	Psychological	Adults	Group or individual CBT-T, EMDR, and stress management are recommended.
		Children	Group or individual CBT-T and EMDR are recommended. Stress management may be beneficial.
	Pharmacological	Adults	SSRIs and TCAs should not be offered as first-line treatment but may be considered if psychological interventions are not available or if there is co-occurring depression.
		Children	Antidepressants should not be used.
Bereavement	Psychological	Adults	Structured psychological interventions should not be universally offered. General principles of care (providing and mobilizing social support, encouraging culturally appropriate mourning) should be used.
		Children
	Pharmacological	Adults	Benzodiazepines should not be offered for individuals who do not meet criteria for a mental disorder.
		Children

Abbreviations: PFA psychological first aid, EMDR eye movement desensitization and reprocessing, CBT-T cognitive behavioral therapy with trauma focus, SSRI selective serotonin reuptake inhibitor, TCA tricyclic antidepressant

^aNo recommendation could be given due to insufficient evidence