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Delivering online cognitive behavioural therapy (iCBT) to address mental health challenges in correctional officers and other public safety personnel

Keywords: Internet-Delivered Cognitive Behavioural Therapy (ICBT), Mental Health Issues, Suicide

Summary

This multiphase clinical study will investigate the efficacy of an electronically delivered cognitive behavioural therapy (e-CBT) program tailored to correctional workers’ (CW) mental health needs. Online mental health treatment, delivered in a safe and secure environment, may be a unique solution to increase access to care for CWs and lower the stigma attached to treatment. In addition, a unique benefit of e-CBT is that treatment can be provided in the privacy of an individuals’ home. One mode of mental health support, proven effective for online delivery, is Cognitive Behavioral Therapy (CBT). CBT is one of the most widely investigated and practiced forms of psychotherapy, with proven efficacy for many different mental health disorders.

The study has four specific aims reflected in the four phases of the study. In the first phase, interviews and focus groups are used to explore the unique mental health challenges faced by CWs and barriers to receiving care. Here, CWs are given a platform to share their mental health experiences as it relates to their occupation and personal life. The second aim is to use the qualitative data to develop e-CBT modules that address mental disorders prevalent in CWs – specifically, major depressive disorder (MDD), generalized anxiety disorder (GAD), and post-traumatic stress disorder (PTSD). A randomized controlled trial (RCT) will be conducted in the third phase to evaluate the efficacy of these mental health programs. Lastly, the efficacy of the e-CBT programs will be compared to their in-person counterparts.

Interview with the Researchers

Are there any additional questions or challenges that your research might help to address?

The most important part of our project is to develop a mental health care platform that can be easily accessed, is affordable, and is customized to meet the unique needs of CWs. To do this, we need to obtain a more fulsome understanding of how CWs perceive their work environment and its effect on their mental health. This information will be used to customize and develop treatments that address the needs expressed by this population.

What is exciting about your work for the PSP community? For example, how will your results help PSP frontline workers? PSP families? PSP leaders?

Often times, CWs suffering from mental disorders are reluctant or unable to pursue in-person psychotherapy. Some barriers to in-person therapy include geographical isolation, social stigma, and costs. Currently, the demand for CBT exceeds resources, leaving many patients and CWs without access to evidence-based care. It is therefore paramount to overcome these barriers and pursue alternative methods. If proven effective, e-CBT could provide an accessible option for CWs to easily seek appropriate treatment without worrying about the stigma of receiving care. If proven non-inferior to in-person therapy, this method could massively expand the therapy capacity in the public sector without compromising the quality of care.

When do you expect to have results to share with the PSP community?

We are currently preparing to publish a narrative review that describes important factors to consider when designing online mental health interventions for CWs. Moreover, after completing our second female focus group, the first phase of our study will be completed.  We aim to publish these findings within the next 3-4 months, titled: A qualitative exploration of the mental health challenges and therapeutic needs of Canadian correctional workers.

Where can PSP go to learn more about your study or, if applicable, to participate? For example, do you have a website?

Details of our CW study as well as other ongoing studies can be found on the Queen’s University Online Psychotherapy Lab (QUOPL) webpage: https://www.queensopl.ca/activeresearch

Additionally, individuals interested in participating in our study can self-refer from our website: https://www.queensopl.ca/self-referral-page OR email us at: opt4.ecbt@queensu.ca

Is there anything else you would like to share with the PSP community about your research?

Our research team is working diligently to ensure that our project has a meaningful impact on the mental health care provided to CWs. We welcome any feedback from stakeholders and community members on how to improve our platform to better meet the mental health needs of CWs. Questions and comments can be directed to opt4.ecbt@queensu.ca.

Researchers

Principal Researcher- Dr. Nazanin Alavi, a staff psychiatrist and assistant professor at the Department of Psychiatry at Queen’s University. Previously, she was a staff psychiatrist at the Centre for Addiction and Mental Health (CAMH) and the Department of Psychiatry at the University of Toronto. Dr. Alavi’s research focuses on the effectiveness of online Cognitive Behavioural Therapy (CBT) in treating mood and anxiety disorders. Dr. Alavi is a pioneer of online CBT in Canada, with more than 12 years of research experience delivering online psychotherapy. She successfully led multiple clinical trials evaluating the efficacy of e-CBT and e-DBT in addressing mood, anxiety, and personality disorders. In addition, she has authored numerous peer-reviewed publications pertaining to online care delivery and published the first handbook on delivering online CBT: Online Cognitive Behavioral Therapy: An E-Mental Health Approach to Depression and Anxiety.

Additional details on our research team can be found on: https://www.queensopl.ca/team

 

Video Presentation

 

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