scholarly journals Delivering an online cognitive behavioural therapy program to address mental health challenges faced by correctional workers and other public safety personnel: Protocol (Preprint)

10.2196/30845 ◽  
2021 ◽  
Author(s):  
Nazanin Alavi ◽  
Callum Stephenson ◽  
Mohsen Omrani ◽  
Cory Gerritsen ◽  
Michael S Martin ◽  
...  
Keyword(s):  
Mental Health ◽  
Cognitive Behavioural Therapy ◽  
Public Safety ◽  
Behavioural Therapy ◽  
Therapy Program ◽  
Public Safety Personnel ◽  
Cognitive Behavioural ◽  
Mental Health Challenges ◽  
Safety Personnel

Initial Outcomes of Transdiagnostic Internet-Delivered Cognitive Behavioural Therapy Tailored for Public Safety Personnel: A Longitudinal Observational Study (Preprint)

2021 ◽  
Author(s):  
Heather D. Hadjistavropoulos ◽  
Hugh C. McCall ◽  
David L. Thiessen ◽  
Ziyin Huang ◽  
R. Nicholas Carleton ◽  
...  
Keyword(s):  
Social Anxiety ◽  
Working Alliance ◽  
Cognitive Behavioural Therapy ◽  
Treatment Satisfaction ◽  
Public Safety ◽  
Behavioural Therapy ◽  
Ptsd Symptoms ◽  
Public Safety Personnel ◽  
Cognitive Behavioural ◽  
Safety Personnel

BACKGROUND Canadian public safety personnel (PSP) experience high rates of mental health disorders and face many barriers to treatment. Internet-delivered cognitive behavioural therapy (ICBT) overcomes many such barriers and is effective for treating depression, anxiety, and posttraumatic stress disorder (PTSD) symptoms. OBJECTIVE The current study was designed to fill a gap in the literature regarding the use of ICBT tailored specifically for PSP. We examined the effectiveness of a tailored ICBT program for treating depression, anxiety, and PTSD symptoms among PSP in the province of Saskatchewan. METHODS We employed a longitudinal single-group open trial design (n = 83) with outcome measures administered at screening and eight weeks. Data was collected between December 5, 2019 and September 11, 2020. Primary outcomes included changes in depression, anxiety, and PTSD symptoms. Secondary outcomes included changes in functional impairment and symptoms of panic, social anxiety, and anger, as well as treatment satisfaction, working alliance, and program usage patterns. RESULTS Clients reported large symptom reductions on measures of depression and anxiety, as well as moderate reductions on measures of PTSD and secondary symptoms, except for social anxiety. Most clients who reported symptoms above clinical cut-offs on measures of depression, anxiety, and PTSD during screening experienced clinically significant symptom reductions. Results suggested good engagement, treatment satisfaction, and working alliance. CONCLUSIONS Tailored, transdiagnostic ICBT demonstrated promising outcomes as a treatment for depression, anxiety, and PTSD among Saskatchewan PSP and warrants further investigation. CLINICALTRIAL clinicaltrials.gov (NCT04127032).

scholarly journals Delivering an online cognitive behavioural therapy program to address mental health challenges faced by correctional workers and other public safety personnel: Protocol (Preprint)

2021 ◽  
Author(s):  
Nazanin Alavi ◽  
Callum Stephenson ◽  
Mohsen Omrani ◽  
Cory Gerritsen ◽  
Michael S Martin ◽  
...  
Keyword(s):  
Mental Health ◽  
Public Safety ◽  
Mental Health Problems ◽  
Phase 1 ◽  
Behavioural Therapy ◽  
Health Problems ◽  
Participant Recruitment ◽  
Public Safety Personnel ◽  
Cognitive Behavioural ◽  
Safety Personnel

BACKGROUND Public safety personnel have regular and often intense exposure to potentially traumatic events at work, especially workplace violence in the case of correctional workers. Subsequently, correctional workers are at higher risk for developing mental health problems such as posttraumatic stress disorder. Public safety personnel are up to 4 times more likely to experience suicidal ideation, attempts, and death by suicide compared to the general population. Despite this high prevalence, help-seeking behaviours from public safety personnel are low due to stigma and irregular work hours limiting access to care. Innovative treatments are needed to address these challenges. OBJECTIVE This study will investigate the efficacy of an electronically delivered cognitive behavioural therapy (e-CBT) program tailored to correctional workers’ mental health problems. METHODS This study is composed of 4 phases. Phase 1 will interview correctional workers individually and in focus groups to identify personal, social, and cultural factors affecting their mental health and barriers to care. Phase 2 will use the information gathered from the interviews to develop gender and diagnosis-specific e-CBT modules. These will be presented to a new group of participants who will provide further feedback on their usability and accessibility. Phase 3 will randomly assign participants to either an e-CBT or treatment as usual arm. The program will be evaluated with validated symptomatology questionnaires and interviews. Phase 4 will use this additional information to fine-tune the e-CBT modules for a larger-scale randomized controlled trial design comparing the e-CBT program to in-person CBT. All e-CBT modules will be delivered through a secure online platform. RESULTS The study received ethics approval in December 2020 and participant recruitment began in March 2021. Participant recruitment has been conducted through targeted advertisements and physician referrals. To date, there have been 15 participants recruited for Phase 1 and it is expected to conclude in July 2021 with phase 2 beginning in September 2021. Complete data collection and analysis from all phases is expected to conclude by July 2023. Linear and binomial regression (continuous and categorical outcomes respectively) will be conducted along with interpretive qualitative methods. CONCLUSIONS If proven efficacious and feasible, this e-CBT program can provide a high-quality and clinically validated resource to address the mental health problems of correctional workers. Additionally, findings can contribute to the development of innovative treatments for other public safety professions. CLINICALTRIAL ClinicalTrials.gov NCT04666974; clinicaltrials.gov/ct2/show/NCT04666974

scholarly journals Why Do Public Safety Personnel Seek Tailored Internet-Delivered Cognitive Behavioural Therapy? An Observational Study of Treatment-Seekers

2021 ◽  
Vol 18 (22) ◽  
pp. 11972
Author(s):  
Hugh C. McCall ◽  
Caeleigh A. Landry ◽  
Adeyemi Ogunade ◽  
R. Nicholas Carleton ◽  
Heather D. Hadjistavropoulos
Keyword(s):  
Mental Disorders ◽  
Cognitive Behavioural Therapy ◽  
Public Safety ◽  
Mental Healthcare ◽  
Healthcare Services ◽  
Behavioural Therapy ◽  
Work Related ◽  
Public Safety Personnel ◽  
Cognitive Behavioural ◽  
Safety Personnel

First responders and other public safety personnel (PSP) experience elevated rates of mental disorders and face unique barriers to care. Internet-delivered cognitive behavioural therapy (ICBT) is an effective and accessible treatment that has demonstrated good treatment outcomes when tailored specifically for PSP. However, little is known about how PSP come to seek ICBT. A deeper understanding of why PSP seek ICBT can inform efforts to tailor and disseminate ICBT and other treatments to PSP. The present study was designed to (1) explore the demographic and clinical characteristics, motivations, and past treatments of PSP seeking ICBT, (2) learn how PSP first learned about ICBT, and (3) understand how PSP perceive ICBT. To address these objectives, we examined responses to online screening questionnaires among PSP (N = 259) who signed up for an ICBT program tailored for PSP. The results indicate that most of our sample experienced clinically significant symptoms of multiple mental disorders, had received prior mental disorder diagnoses and treatments, heard about ICBT from a work-related source, reported positive perceptions of ICBT, and sought ICBT to learn skills to manage their own symptoms of mental disorders. The insights gleaned through this study have important implications for ICBT researchers and others involved in the development, delivery, evaluation, and funding of mental healthcare services for PSP.

scholarly journals Digital cognitive–behavioural therapy for insomnia compared with digital patient education about insomnia in individuals referred to secondary mental health services in Norway: protocol for a multicentre randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e050661
Author(s):  
Håvard Kallestad ◽  
Simen Saksvik ◽  
Øystein Vedaa ◽  
Knut Langsrud ◽  
Gunnar Morken ◽  
...  
Keyword(s):  
Mental Health ◽  
Randomised Controlled Trial ◽  
Patient Education ◽  
Cognitive Behavioural Therapy ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Group Differences ◽  
Post Intervention ◽  
Cognitive Behavioural ◽  
Randomised Controlled

IntroductionInsomnia is highly prevalent in outpatients receiving treatment for mental disorders. Cognitive–behavioural therapy for insomnia (CBT-I) is a recommended first-line intervention. However, access is limited and most patients with insomnia who are receiving mental healthcare services are treated using medication. This multicentre randomised controlled trial (RCT) examines additional benefits of a digital adaptation of CBT-I (dCBT-I), compared with an online control intervention of patient education about insomnia (PE), in individuals referred to secondary mental health clinics.Methods and analysisA parallel group, superiority RCT with a target sample of 800 participants recruited from treatment waiting lists at Norwegian psychiatric services. Individuals awaiting treatment will receive an invitation to the RCT, with potential participants undertaking online screening and consent procedures. Eligible outpatients will be randomised to dCBT-I or PE in a 1:1 ratio. Assessments will be performed at baseline, 9 weeks after completion of baseline assessments (post-intervention assessment), 33 weeks after baseline (6 months after the post-intervention assessment) and 61 weeks after baseline (12 months after the post-intervention assessment). The primary outcome is between-group difference in insomnia severity 9 weeks after baseline. Secondary outcomes include between-group differences in levels of psychopathology, and measures of health and functioning 9 weeks after baseline. Additionally, we will test between-group differences at 6-month and 12-month follow-up, and examine any negative effects of the intervention, any changes in mental health resource use, and/or in functioning and prescription of medications across the duration of the study. Other exploratory analyses are planned.Ethics and disseminationThe study protocol has been approved by the Regional Committee for Medical and Health Research Ethics in Norway (Ref: 125068). Findings from the RCT will be disseminated via peer-reviewed publications, conference presentations, and advocacy and stakeholder groups. Exploratory analyses, including potential mediators and moderators, will be reported separately from main outcomes.Trial registration numberClinicalTrials.gov Registry (NCT04621643); Pre-results.

Efficacy, effectiveness, and quality of resilience-building mobile health apps for military, veteran and public safety personnel populations: a scoping literature review and app evaluation (Preprint)

2021 ◽  
Author(s):  
Melissa Voth ◽  
Shannon Chisholm ◽  
Hannah Sollid ◽  
Chelsea Jones ◽  
Lorraine Smith-MacDonald ◽  
...  
Keyword(s):  
Mental Health ◽  
Literature Review ◽  
Mobile Health ◽  
Public Safety ◽  
Evidence Based ◽  
Inclusion Criteria ◽  
Public Safety Personnel ◽  
Scoping Literature Review ◽  
Mhealth Apps ◽  
Safety Personnel

BACKGROUND Globally, military members (MM) and public safety personnel (PSP) are vulnerable to occupational stress injuries (OSIs) due to their job demands. Consequently, when MM and PSP transition out of these professions, they may continue to experience mental health challenges. In response to this, resilience building programs are being developed and implemented with the goal of promoting empowerment and primary stress regulation. The development of mobile health (mHealth) applications (apps) as an emergent mental health intervention platform has allowed for targeted, cost effective, and easily accessible treatment when in-person therapy may be limited or unavailable. However, current mHealth app development is not regulated, and often lacks both clear evidence-based research and the input of healthcare professionals. OBJECTIVE The purpose of this manuscript is to evaluate the evidence-based quality, efficacy, and effectiveness of resilience building mobile apps targeted towards MM, PSP, and veteran populations via: (1) a scoping literature review of the current evidence-base regarding resilience apps for these populations, and; (2) evaluation of free resilience apps designed for use amongst these populations. METHODS Studies were selected using a comprehensive search of MEDLINE, CINAHL Plus, PsycINFO, SocINDEX, Academic Search Complete, Embase, and Google and was guided by Preferred Reporting Items for Systematic Reviews and Meta-Analysis for scoping reviews (PRISMA-ScR). The Alberta Rating Index for Apps (ARIA) was utilized to conduct a review of each of the identified apps. Inclusion criteria consisted of apps: 1) free to download in either Google Play or the App Store; 2) updated within the last 3 years; 3) available in English and in Canada; and 4) intended for use by MM and/or PSP. RESULTS Twenty-two apps met the inclusion criteria for evaluation. The resilience strategies offered by the majority of apps included psychoeducation, mindfulness, Cognitive Behavioural Therapy (CBT), and Acceptance and Commitment Therapy (ACT). Eleven apps (50%) had been tested with randomized controlled trials, seven (31.8%) were evaluated using other research methods, and five (22.7%) had not been researched. Using the ARIA, apps scores ranged from 37 to 56 out of 72 with higher rated apps demonstrating increased useability and security features. CONCLUSIONS The mHealth apps reviewed are well suited to providing resilience strategies for MMs, PSP and veterans. They offer easy accessibility to evidence-based tools while working to encourage the use of emotional and professional support with safety in mind. While not intended to function as a substitute for professional services, research has demonstrated that mHealth apps have the potential to foster a significant reduction in symptom severity for PTSD, depression, anxiety, and other stress-induced concerns. Within clinical practice, apps can be utilized to supplement treatment as well as provide clients with population-specific, confidential tools to increase engagement in the treatment process. CLINICALTRIAL N/A

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