A Literature Review on the Role of Paraprofessionals in Delivering Brief Psychological Interventions

The global demand for mental health services exceeds available resources, particularly in low- and middle-income countries where access remains limited. Even in high-resource nations, many individuals still lack adequate care, a gap exacerbated by the COVID-19 pandemic. Brief psychological interventions (BPIs) offer a structured, short-term therapeutic approach to address this need. Typically delivered in fewer than ten sessions, BPIs incorporate evidence-based therapy components and can be administered by paraprofessionals, non-credentialed individuals trained to provide mental health support. This review synthesizes research on paraprofessionally delivered BPIs by describing study characteristics across populations, settings, and intervention modalities, characterizing the paraprofessional workforce, and summarizing reported mental health outcomes and patterns of effectiveness. A PsycINFO and PubMed search identified 47 articles, including 45 unique studies. To provide a clearer picture of effectiveness, box-score analyses were conducted on randomized controlled trials (RCTs) and pilot/feasibility RCTs. Findings indicate that paraprofessional-delivered BPIs, particularly those grounded in cognitive-behavioral therapy (CBT) and delivered remotely, are consistently effective across diverse populations and contexts. The evidence base is strongest for adult populations and posttraumatic stress disorder (PTSD) outcomes, with weaker support for adolescents and school-based programs. Paraprofessionals' cultural and community alignment also enhanced engagement and reduced stigma-related barriers. Nonetheless, inconsistencies in training, supervision, intervention fidelity, and recruitment criteria present challenges for scalability. This review highlights the absence of a rigorously tested definition of BPIs and the lack of consensus on the term paraprofessional. It underscores the need for standardized training and supervision guidelines to ensure fidelity and sustainability. Further research is essential to refine best practices and optimize paraprofessionals' integration into mental health systems, thereby improving accessibility and equity.