Supplemental Material for Stakeholder Perspectives on Internet-Delivered Cognitive Behavioural Therapy for Public Safety Personnel: A Qualitative Analysis

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).

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

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182211972 ◽

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.

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

JMIR Research Protocols ◽

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

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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/preprints.30845 ◽

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

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8. Therapeutic and Educational Potential of Combining Cognitive Behavioural Therapy and Art – Qualitative Analysis of a Case Study

Review of Artistic Education ◽

10.1515/rae-2016-0032 ◽

2016 ◽

Vol 12 (2) ◽

pp. 268-276 ◽

Cited By ~ 1

Author(s):

Michal Růžička ◽

Kristýna Krahulcová ◽

Jan Chrastina

Keyword(s):

Qualitative Analysis ◽

Case Studies ◽

Cognitive Behavioural Therapy ◽

Behavioural Therapy ◽

Cognitive Behavioural ◽

Wide Range ◽

Subsequent Application ◽

Research Questions ◽

Educational Potential

Abstract Cognitive behavioural psychotherapy is, just like other psychotherapeutic systems, of an eclectic nature. Should a therapist be successful across a wide range of issues, he/she needs to be adaptable, flexible and eclectic in terms of the techniques applied. Eclectically oriented therapists use a wide range of interventions; however, they adhere to individual theoretical structures. The aim of the paper is to point out the application of a combination of artistic activities within the system of the Cognitive behavioural therapy. For this purpose the paper presents a qualitative analysis of two case studies. We formulated the following research questions. Can the methods of combining the cognitive behavioural therapy and art accelerate the course of therapy? Can the methods of combining the cognitive behavioural therapy and art be perceived by the client as effective? The phenomenon investigated in the case study is a functional analysis of a client’s case and subsequent application of therapeutic and educational techniques of the Cognitive behavioural therapy and art. In both case studies it was demonstrated that the involvement of therapeutic elements accelerated the course of therapy. The clients in the research sample assessed the therapy as beneficial.

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