The goal of this project is to enhance and evaluate the efficacy of a scalable digital solution designed to help train and support the work of non-specialist providers (NSPs), such as community health workers, to deliver therapy to individuals with anxiety and/or depression. The main questions this project aims to answer are:

• Can a digital tool help NSPs feel more confident in counseling patients?
• How can a digital tool be designed to optimally support the work of NSPs?

There is a critical shortage of mental health specialists (i.e., psychiatrists, psychologists, licensed mental health counselors) and a growing mental health crisis in the US. Task sharing, whereby highly qualified health workers share specific tasks non-specialist providers (NSPs) with less training and fewer qualifications in order to make more efficient use of the available human resources, is an approach that can scale and address unmet mental health needs, particularly in hard-to-reach communities with limited to no access to specialist care. The investigators propose a comprehensive solution to support a task sharing approach for delivering high quality brief psychosocial interventions. Our proposed digital platform is designed to support measurement-based peer supervision (MBPS), which includes the ability for NSPs to record therapy sessions, rate them using a validated quality scale, and review ratings safely and securely with peers in moderated group discussions. The investigators developed and successfully demonstrated acceptability, usability, and potential feasibility of digitally-enabled MBPS to support NSP performance and quality of care in Phase I. The goal of this Phase II project is to enhance and evaluate the efficacy of this digitally-enabled MBPS tool with NSPs working directly in communities. The investigators will address this goal with three specific aims.

In Aim 1, the investigators will build an enhanced version of the digital platform based on Phase I feedback and direct input from NSPs.

In Aim 2, the investigators will conduct a mixed methods evaluation of digitally-enabled MBPS with 50 target end users, i.e., NSPs recruited from a large health system in Texas and recently trained in behavioral activation. During this period, NSPs will engage in mock sessions with standardized patients. Primary outcomes of interest will be NSP session quality in delivering behavioral activation therapy and counselor self-efficacy.

Results of this Phase II work can provide important insights to guide the implementation and scaling of effective delivery of psychosocial interventions and program quality improvement, with the long-term goal of improving mental health outcomes in hard-to-reach communities that can benefit the most from NSP-led support.

Inclusion Criteria:

• 18 years of age or older;
• English-speaking; and
• Completed EMPOWER Behavioral Activation training

Exclusion Criteria:

- Unable to participate in virtual meetings

There is currently no plan to share individual participant data; results will ll be reported in aggregate.