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ENhancing Assessment of Common Therapeutic Factors (ENACT)


ENACT tool and role-play with standardised client

Common factors refer to those competencies that are assumed to be universal for the delivery of any effective psychological treatment. Common factors typically include skills that relate to building a warm, trustworthy relationship between the provider and client such as building rapport, using verbal and non-verbal communication skills, demonstrating empathy and genuineness, and working as a team to help the person receiving services feel better. 

An important aspect of quality control when non-specialists deliver mental health services is to ensure that they meet minimum competency criteria to assure safety and increase the likelihood that the interventions will be effective. Competency is best evaluated using structured role-plays with standardized clients, i.e., mock clients who are acting out a scripted role. The National Institutes of Mental Health (NIMH, K01 MH104310) funded the development, led by Dr. Brandon Kohrt, of the ENhancing Assessment of Common Therapeutic factors (ENACT) role-play assessment tool that supports a structured role-play and evaluation approach for trainers and supervisors working with non-specialists in cross-cultural teams.


This global tool has been evaluated in multiple countries with a range of non-specialist and specialist provider populations, and based on the success of this tool in multiple sites, the World Health Organization (WHO) decided to use ENACT as the foundation for a new online training and guidance platform: Ensuring Quality in Psychological Support (EQUIP, 

ENACT is available in paper format (PDF) and is currently being evaluated as a digital assessment tool within the EQUIP project. It has been translated in multiple languages including Amharic, Arabic, Nepali, Spanish, and Tigrinya.  

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