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Harnas SJ, Knoop H, Sprangers MAG, Braamse AMJ. Defining and operationalizing personalized psychological treatment - a systematic literature review. Cogn Behav Ther 2024; 53:467-489. [PMID: 38535891 DOI: 10.1080/16506073.2024.2333345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 03/15/2024] [Indexed: 04/10/2024]
Abstract
This systematic literature review aimed to propose a definition of personalized psychological treatment and to suggest how the definition can be operationalized. PsycINFO, Cochrane Library, MEDLINE and EMBASE were searched up to 11 December 2023 for studies in which a definition of personalized psychological treatment was included or a systematic operationalization of personalized psychological treatment was described. Based on a narrative synthesis of the collected definitions, summary categories were developed that informed the proposed definition. Operationalizations were described according to what aspect of treatment, how and when treatment was personalized. The extent to which the operationalizations deviated from the proposed definition was assessed. Thirty-four studies with definitions and 200 with operationalizations were included. The following definition was proposed: personalized psychological treatment aims to optimize treatment outcome for the individual patient by tailoring treatment to unique or specific needs, preferences or other characteristics and includes a systematic adaptation of treatment or a differentiation between treatment strategies. Based on the operationalizations, timing of personalization, specification of the systematic approach and treatment elements that could be personalized were added to the proposed definition. Evidence-based personalization of psychological treatments can be enhanced by clear operationalization based on a comprehensive definition of personalization.
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Affiliation(s)
- Susan J Harnas
- Department of Medical Psychology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Cancer Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, The Netherlands
- Mental Health, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Hans Knoop
- Department of Medical Psychology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Cancer Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, The Netherlands
- Mental Health, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Mirjam A G Sprangers
- Department of Medical Psychology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Cancer Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, The Netherlands
- Mental Health, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Annemarie M J Braamse
- Department of Medical Psychology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Cancer Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, The Netherlands
- Mental Health, Amsterdam Public Health, Amsterdam, The Netherlands
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Moghimi E, Stephenson C, Agarwal A, Nikjoo N, Malakouti N, Layzell G, O'Riordan A, Jagayat J, Shirazi A, Gutierrez G, Khan F, Patel C, Yang M, Omrani M, Alavi N. Efficacy of an Electronic Cognitive Behavioral Therapy Program Delivered via the Online Psychotherapy Tool for Depression and Anxiety Related to the COVID-19 Pandemic: Pre-Post Pilot Study. JMIR Ment Health 2023; 10:e51102. [PMID: 37993984 PMCID: PMC10760511 DOI: 10.2196/51102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 11/17/2023] [Accepted: 11/21/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Lockdowns and social distancing resulting from the COVID-19 pandemic have worsened the population's mental health and made it more difficult for individuals to receive care. Electronic cognitive behavioral therapy (e-CBT) is a cost-effective and evidence-based treatment for anxiety and depression and can be accessed remotely. OBJECTIVE The objective of the study was to investigate the efficacy of online psychotherapy tailored to depression and anxiety symptoms during the pandemic. METHODS The pilot study used a pre-post design to evaluate the efficacy of a 9-week e-CBT program designed for individuals with depression and anxiety affected by the pandemic. Participants were adults (N=59) diagnosed with major depressive disorder and generalized anxiety disorder, whose mental health symptoms initiated or worsened during the COVID-19 pandemic. The online psychotherapy program focused on teaching coping, mindfulness, and problem-solving skills. Symptoms of anxiety and depression, resilience, and quality of life were assessed. RESULTS Participants demonstrated significant improvements in symptoms of anxiety (P=.02) and depression (P=.03) after the intervention. Similar trends were observed in the intention-to-treat analysis. No significant differences were observed in resilience and quality-of-life measures. The sample comprised mostly females, making it challenging to discern the benefits of the intervention in males. Although a pre-post design is less rigorous than a controlled trial, this design was selected to observe changes in scores during a critical period. CONCLUSIONS e-CBT for COVID-19 is an effective and accessible treatment option. Improvements in clinical symptoms of anxiety and depression can be observed in individuals whose mental health is affected by the COVID-19 pandemic. TRIAL REGISTRATION ClinicalTrials.gov NCT04476667; https://clinicaltrials.gov/study/NCT04476667. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/24913.
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Affiliation(s)
- Elnaz Moghimi
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Callum Stephenson
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Anika Agarwal
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Niloofar Nikjoo
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Niloufar Malakouti
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | - Gina Layzell
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Anne O'Riordan
- Patient and Family Centered Care, Kingston Health Sciences Centre, Kingston, ON, Canada
| | - Jasleen Jagayat
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | | | - Gilmar Gutierrez
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Ferwa Khan
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Charmy Patel
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Megan Yang
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Mohsen Omrani
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
- OPTT Inc, Toronto, ON, Canada
| | - Nazanin Alavi
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
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Stephenson C, Moghimi E, Shao Y, Kumar A, Yee CS, Miller S, Stefatos A, Gholamzadehmir M, Abbaspour Z, Jagayat J, Shirazi A, Gizzarelli T, Gutierrez G, Khan F, Patel C, Patel A, Yang M, Omrani M, Alavi N. Comparing the efficacy of electronic cognitive behavioral therapy to medication and combination therapy for generalized anxiety disorder: a quasi-experimental clinical trial. Front Psychiatry 2023; 14:1194955. [PMID: 38125282 PMCID: PMC10732166 DOI: 10.3389/fpsyt.2023.1194955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 11/16/2023] [Indexed: 12/23/2023] Open
Abstract
Background Generalized anxiety disorder (GAD) is a debilitating mental health disorder with first-line treatments include cognitive behavioral therapy (CBT) and pharmacotherapy. CBT is costly, time-consuming, and inaccessible. Electronic delivery (e-CBT) is a promising solution to address these barriers. However, due to the novelty of this intervention, more research testing the e-CBT efficacy independently and in conjunction with other treatments is needed. Objective This study investigated the efficacy of e-CBT compared to and in conjunction with pharmacotherapy for GAD. Methods This study employed a quasi-experimental design where patients selected their preferred treatment modality. Patients with GAD were enrolled in either e-CBT, medication, or combination arms. The 12-week e-CBT program was delivered through a digital platform. The medications followed clinical guidelines. The efficacy of each arm was evaluated using questionnaires measuring depression, anxiety, and stress severity, as well as quality of life. Results There were no significant differences between arms (N e-CBT = 41; N Medication = 41; N Combination = 33) in the number of weeks completed or baseline scores. All arms showed improvements in anxiety scores after treatment. The medication and combination arms improved depression scores. The e-CBT and Combination arms improved quality of life, and the combination arm improved stress scores. There were no differences between the groups in depression, anxiety, or stress scores post-treatment. However, the combination arm had a significantly larger improvement in quality of life. Gender and treatment arm were not predictors of dropout, whereas younger age was. Conclusion Incorporating e-CBT on its own or in combination with pharmaceutical interventions is a viable option for treating GAD. Treating GAD with e-CBT or medication appears to offer significant improvements in symptoms, with no meaningful difference between the two. Combining the treatments also offer significant improvements, while not necessarily superior to either independently. The findings suggest that all options are viable. Taking the patient's preferred treatment route based on their lifestyle, personality, and beliefs into account when deciding on treatment should be a priority for care providers.
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Affiliation(s)
- Callum Stephenson
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Elnaz Moghimi
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Yijia Shao
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
- Department of Psychology, Faculty of Arts and Science, University of Toronto, Toronto, ON, Canada
| | - Anchan Kumar
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Caitlin S. Yee
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Shadé Miller
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Anthi Stefatos
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Maedeh Gholamzadehmir
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Zara Abbaspour
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Jasleen Jagayat
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
- Centre for Neuroscience Studies, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Amirhossein Shirazi
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
- OPTT Inc., Digital Media Zone, Ryerson University, Toronto, ON, Canada
| | - Tessa Gizzarelli
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Gilmar Gutierrez
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Ferwa Khan
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Charmy Patel
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Archana Patel
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Megan Yang
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
- Centre for Neuroscience Studies, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Mohsen Omrani
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
- OPTT Inc., Digital Media Zone, Ryerson University, Toronto, ON, Canada
| | - Nazanin Alavi
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
- Centre for Neuroscience Studies, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
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Stephenson C, Moghimi E, Gutierrez G, Jagayat J, Layzell G, Patel C, Omrani M, Alavi N. User experiences of an online therapist-guided psychotherapy platform, OPTT: A cross-sectional study. Internet Interv 2023; 32:100623. [PMID: 37273941 PMCID: PMC10235428 DOI: 10.1016/j.invent.2023.100623] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 04/17/2023] [Accepted: 04/20/2023] [Indexed: 06/06/2023] Open
Abstract
Introduction In the last few years, online psychotherapy programs have burgeoned since they are a more accessible and scalable treatment option compared to in-person therapies. While these online programs are promising, understanding the user experience and perceptions of care is essential for program optimization. Methods This study investigated the experiences of end-users who had previously received online psychotherapy through a web-based platform. A 35-item multiple-choice survey was developed by the research team and distributed to past users to capture their perceptions of the program. Results The survey yielded 163 responses, with a 90 % completion rate. Participants were predominantly white and female, with an average age of 42 years. While most participants preferred in-person therapy, they also reported the benefits of the online psychotherapy program. Participants had positive perceptions of the platform, the quality and interaction of their therapist, and the homework assignments and skills covered. Lack of motivation to complete weekly homework assignments was cited as a common struggle. Discussion The findings support online psychotherapy as a beneficial digital mental health tool and highlight some areas for improvement. Scalability and accessibility are key benefits of the platform. At the same time, improvements in participant engagement, including those from equity-seeking and equity-deserving groups, may enhance the efficacy of the programs offered.
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Affiliation(s)
- Callum Stephenson
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, 166 Brock Street, Kingston, Ontario K7L 5G2, Canada
| | - Elnaz Moghimi
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, 166 Brock Street, Kingston, Ontario K7L 5G2, Canada
- Waypoint Research Institute, Waypoint Centre for Mental Health Care, 500 Church Street, Penetanguishene, Ontario L9M 1G3, Canada
| | - Gilmar Gutierrez
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, 166 Brock Street, Kingston, Ontario K7L 5G2, Canada
| | - Jasleen Jagayat
- Centre for Neuroscience Studies, Faculty of Health Sciences, Queen's University, 18 Stuart Street, Kingston, Ontario K7L 3N6, Canada
| | - Georgina Layzell
- Centre for Neuroscience Studies, Faculty of Health Sciences, Queen's University, 18 Stuart Street, Kingston, Ontario K7L 3N6, Canada
| | - Charmy Patel
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, 166 Brock Street, Kingston, Ontario K7L 5G2, Canada
| | - Mohsen Omrani
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, 166 Brock Street, Kingston, Ontario K7L 5G2, Canada
- OPTT Inc., DMZ 10 Dundas Street East, Toronto, Ontario M5B 2G9, Canada
| | - Nazanin Alavi
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, 166 Brock Street, Kingston, Ontario K7L 5G2, Canada
- Centre for Neuroscience Studies, Faculty of Health Sciences, Queen's University, 18 Stuart Street, Kingston, Ontario K7L 3N6, Canada
- OPTT Inc., DMZ 10 Dundas Street East, Toronto, Ontario M5B 2G9, Canada
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5
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Alavi N, Moghimi E, Stephenson C, Gutierrez G, Jagayat J, Kumar A, Shao Y, Miller S, Yee CS, Stefatos A, Gholamzadehmir M, Abbaspour Z, Shirazi A, Gizzarelli T, Khan F, Patel C, Patel A, Yang M, Omrani M. Comparison of online and in-person cognitive behavioral therapy in individuals diagnosed with major depressive disorder: a non-randomized controlled trial. Front Psychiatry 2023; 14:1113956. [PMID: 37187863 PMCID: PMC10175610 DOI: 10.3389/fpsyt.2023.1113956] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 04/10/2023] [Indexed: 05/17/2023] Open
Abstract
Objective The increased prevalence of major depressive disorder (MDD) amid the COVID-19 pandemic has resulted in substantial growth in online mental health care delivery. Compared to its in-person counterpart, online cognitive behavioral therapy (e-CBT) is a time-flexible and cost-effective method of improving MDD symptoms. However, how its efficacy compares to in-person CBT is yet to be explored. Therefore, the current study compared the efficacy of a therapist-supported, electronically delivered e-CBT program to in-person therapy in individuals diagnosed with MDD. Methods Participants (n = 108) diagnosed with MDD selected either a 12 week in-person CBT or an asynchronous therapist-supported e-CBT program. E-CBT participants (n = 55) completed weekly interactive online modules delivered through a secure cloud-based online platform (Online Psychotherapy Tool; OPTT). These modules were followed by homework in which participants received personalized feedback from a trained therapist. Participants in the in-person CBT group (n = 53) discussed sessions and homework with their therapists during one-hour weekly meetings. Program efficacy was evaluated using clinically validated symptomatology and quality of life questionnaires. Results Both treatments yielded significant improvements in depressive symptoms and quality of life from baseline to post-treatment. Participants who opted for in-person therapy presented significantly higher baseline symptomatology scores than the e-CBT group. However, both treatments demonstrated comparable significant improvements in depressive symptoms and quality of life from baseline to post-treatment. e-CBT seems to afford higher participant compliance as dropouts in the e-CBT group completed more sessions on average than those in the in-person CBT group. Conclusion The findings support e-CBT with therapist guidance as a suitable option to treat MDD. Future studies should investigate how treatment accessibility is related to program completion rates in the e-CBT vs. in-person group. Clinical Trial Registration ClinicalTrials.Gov Protocol Registration and Results System (NCT04478058); clinicaltrials.gov/ct2/show/NCT04478058.
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Affiliation(s)
- Nazanin Alavi
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
- Centre for Neuroscience Studies, Queen’s University, Kingston, ON, Canada
- OPTT Inc., Toronto, ON, Canada
- *Correspondence: Nazanin Alavi,
| | - Elnaz Moghimi
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | | | - Gilmar Gutierrez
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Jasleen Jagayat
- Centre for Neuroscience Studies, Queen’s University, Kingston, ON, Canada
| | - Anchan Kumar
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Yijia Shao
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Shadé Miller
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Caitlin S. Yee
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Anthi Stefatos
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | | | - Zara Abbaspour
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | | | - Tessa Gizzarelli
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Ferwa Khan
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Charmy Patel
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Archana Patel
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Megan Yang
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Mohsen Omrani
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
- OPTT Inc., Toronto, ON, Canada
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Bahji A, Di Nota PM, Groll D, Carleton RN, Anderson GS. Psychological interventions for post-traumatic stress injuries among public safety personnel: a systematic review and meta-analysis. Syst Rev 2022; 11:255. [PMID: 36434683 PMCID: PMC9701019 DOI: 10.1186/s13643-022-02112-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 11/02/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Public safety personnel (PSP) are exposed to potentially psychologically traumatic events (PPTE) far more often than the general public, which increases the risk for various post-traumatic stress injuries (PTSIs). While there are many evidence-based psychological interventions for PTSI, the effectiveness of each intervention for PSP remains unclear. OBJECTIVES The current study assessed the effectiveness and acceptability of psychological interventions for PTSI among PSPs. METHODS A systematic review and random-effects meta-analysis were performed on the effectiveness and acceptability of psychotherapies for PTSIs (i.e., symptoms of depression, anxiety, post-traumatic stress disorder) among PSP. The review adhered to the PRISMA reporting guidelines and used standardized mean differences (Cohen's d), rate ratios (RR), and their 95% confidence intervals (95% CI) to measure pooled effect sizes across studies; negative d values and RR values less than one indicated a reduction in symptoms compared to baseline or control groups. In addition, heterogeneity was quantified using I2, and publication bias was evaluated using Egger's test. RESULTS The analyses included data from eight randomized controlled trials representing 402 PSP (79.4% male, 35.3 years). Psychological interventions included narrative exposure therapy (n = 1), cognitive behavioral therapy (n = 2), eclectic psychotherapy (n = 2), eye-movement desensitization and reprocessing (n = 1), supportive counseling (n = 2), and group critical incident stress debriefing (n = 1). The interventions were associated with statistically significant reductions in symptoms associated with PTSD (d = - 1.23; 95% CI - 1.81, - 0.65; 7 studies; I2 = 81%), anxiety (- 0.76; 95% CI - 1.28, - 0.24; 3 studies; I2 = 47%), and depression (d = - 1.10; 95% CI - 1.62, - 0.58; 5 studies; I2 = 64%). There were smaller but statistically significant improvements at follow-up for symptoms of PTSD (d = - 1.29 [- 2.31, - 0.27]), anxiety (d = - 0.82 [- 1.20, - 0.44]), and depression (d = - 0.46 [- 0.77, - 0.14]). There were no statistically significant differences in dropout rates (RR = 1.00 [0.96, 1.05]), suggesting high acceptability across interventions. CONCLUSIONS There is preliminary evidence that psychotherapies help treat PTSIs in PSP; however, the shortage of high-quality studies on PSP indicates a need for additional research into treating PTSI among PSP. SYSTEMATIC REVIEW REGISTRATION PROSPERO: CRD42019133534.
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Affiliation(s)
- Anees Bahji
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Paula M Di Nota
- Office of Applied Research and Graduate Studies, Justice Institute of British Columbia, Vancouver, BC, Canada
| | - Dianne Groll
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
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Moghimi E, Knyahnytska Y, Zhu Y, Kumar A, Knyahnytski A, Patel C, Omrani M, Gerritsen C, Martin M, Simpson AIF, Alavi N. A qualitative exploration of the mental health challenges and therapeutic needs of Canadian correctional workers. Front Psychiatry 2022; 13:1004143. [PMID: 36386978 PMCID: PMC9641701 DOI: 10.3389/fpsyt.2022.1004143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/07/2022] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Correctional work is described as a high-stress environment associated with increased prevalence of mental health disorders in employees. Identifying appropriate healthcare services necessitates investigating the mental health challenges and needs of correctional workers (CWs). METHODS Individual interviews (n = 9; 5 M and 4 W) and a mixed gender focus group (n = 6; 3 M and 3 W) were conducted to gather a general sense of the mental health landscape. Data were analyzed to develop a targeted and comprehensive question guide for gender-specific focus groups (n = 14 unique participants; 6 M and 8 W). RESULTS Eight themes emerged from the gender-specific focus groups. Themes focusing on work culture described the negative repercussions of job stress and the inability to discuss challenges openly due to confidentiality concerns and feelings of seclusion associated with the CW profession. Men were more likely to be subjected to physical violence and women to emotional and sexual harassment from staff and inmates. Themes related to mental health care described the benefits and limitations of the current services and digital mental healthcare. Stigma and accessibility were notable treatment barriers. Lastly, sector-specific therapy was seen as an important component in enhancing engagement and therapist interaction. CONCLUSION The study demonstrates the interconnection between work culture and CW mental health that needs to be acknowledged when addressing mental health care.
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Affiliation(s)
- Elnaz Moghimi
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | | | - Yiran Zhu
- Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Anchan Kumar
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | | | - Charmy Patel
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Mohsen Omrani
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada.,OPTT Inc., Toronto, ON, Canada
| | - Cory Gerritsen
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Michael Martin
- Correctional Service of Canada, Ottawa, ON, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | | | - Nazanin Alavi
- Department of Psychiatry, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada.,OPTT Inc., Toronto, ON, Canada.,Faculty of Health Sciences, Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
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8
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McCall HC, Landry CA, Ogunade A, Carleton RN, Hadjistavropoulos HD. 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 2021; 18:ijerph182211972. [PMID: 34831728 PMCID: PMC8619750 DOI: 10.3390/ijerph182211972] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/10/2021] [Accepted: 11/13/2021] [Indexed: 11/16/2022]
Abstract
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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Affiliation(s)
- Hugh C. McCall
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada; (H.C.M.); (C.A.L.); (R.N.C.)
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada;
| | - Caeleigh A. Landry
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada; (H.C.M.); (C.A.L.); (R.N.C.)
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada;
| | - Adeyemi Ogunade
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada;
| | - R. Nicholas Carleton
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada; (H.C.M.); (C.A.L.); (R.N.C.)
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada;
| | - Heather D. Hadjistavropoulos
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada; (H.C.M.); (C.A.L.); (R.N.C.)
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada;
- Correspondence:
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