Early, Late and Sequential Psychosocial Mediators of Reduction in Depression Symptoms Six Months Following Group Support Psychotherapy among People Living with HIV in Uganda: A Longitudinal Mediation Analysis

Participants increasingly used practical coping strategies, reduced self-blame and denial, and strengthened their social connections. These later improvements helped maintain recovery over time. We also found that when participants started actively seeking emotional support during therapy, this often led to continued help-seeking afterwards, which further supported longer-term improvement.

Overall, the findings suggest that GSP works by first helping people process emotions safely, and then building stronger coping skills and social support systems that protect against relapse. Understanding these stages can help refine and strengthen future mental health interventions.