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This BMC Psychiatry research paper outlines the study protocol for research to assess the effectiveness and cost-effectiveness of the WHO’s Problem Management Plus (PM+) in conflict-affected Pakistan. It will conduct a randomised controlled trial compare the effectiveness of the locally adapted PM+ to the Treatment as usual (TAU) in the Peshawar District of Pakistan.

After informed consent, primary care attendees with high levels of psychological distress according to the General Health Questionnaire-12 (GHQ-12) and functional impairment (WHO Disability Assessment Schedule 2.0 (WHODAS)) will be assigned to PM+ (n = 173) or TAU (n = 173). At baseline, 1 week and 3 months following PM+, independent assessors will assess psychological distress with the Hospital Anxiety and Depression Scale (HADS), and functional disability with the WHODAS. Secondary outcomes are posttraumatic stress disorder (PTSD) symptoms, and client-perceived priority problems. Further, cost-effectiveness will be assessed using the Service Receipt Inventory (SRI).

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