Effects of Mental Health Paraprofessional Training for Filipina Foreign Domestic Workers in Singapore

  • M. H. M. Wong
  • Shian-Ling KengEmail author
  • P. J. Buck
  • S. Suthendran
  • A. Wessels
  • T. Østbye
Original Paper


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 [1]. 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.


Cognitive 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.

Ethical approval

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.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of PsychologyNational University of SingaporeSingaporeSingapore
  2. 2.Division of Social ScienceYale-NUS CollegeSingaporeSingapore
  3. 3.Portland Dialectical Behavior Therapy InstitutePortlandUSA
  4. 4.Humanitarian Organization for Migration EconomicsSingaporeSingapore
  5. 5.Research Across BordersSydneyAustralia
  6. 6.Center for Aging Research and EducationDuke-NUS Medical SchoolSingaporeSingapore

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