Firefighters Accessing Care for Trauma: A Clinical Case Series of Distance NET for PTSD/I Symptoms

NCT04386330 | Completed

• 1 other identifier: 22081
• Study Type: interventional
• Target: 19
• Locations: 1 country
• Sites: 1

Brief Summary

Repeated exposure to trauma is an unavoidable part of the job for firefighters. Because of this, many Canadian firefighters screen positive for posttraumatic stress disorder/injury (PTSD/I). Unfortunately, like the general population, firefighters face many barriers to accessing mental health care. As a result, additional efforts are needed to increase timely access to effective PTSD/I services that are delivered in a way that reduces confidentiality and stigma risk. This research study will test the preliminary efficacy and feasibility of distance-delivered Narrative Exposure Therapy (NET) delivered by a paraprofessional for firefighters with PTSD/I. NET is an evidence-based intervention approach developed specifically for PTSD/I resulting from repeated and continuous trauma. The intervention will be conducted via videoconference with a trained paraprofessional supervised by a clinical psychologist. The NET intervention will consist of 12 weekly 90-minute videoconference sessions. Approximately 25 firefighters will be recruited to participate in the study. To test the efficacy of the intervention, participants will complete self-report questionnaires about PTSD/I and other mental health symptoms pre- and post-intervention as well as two- and six-months following intervention completion. Participants will also complete an open-ended interview at the end of the intervention to assess feasibility and participant satisfaction.

Conditions

Post Traumatic Stress Disorder; Post Traumatic Stress Injury

Outcome Measures

Primary Outcomes (3)

• Change in PTSD/I symptoms

  PTSD/I symptoms are measured with the PTSD Checklist - 5 (PCL-5)

  Baseline, Immediately Post- intervention, 2 month follow up, 6 month follow up

• Change in depressive symptoms

  Depression symptoms will be measured using the Patient Health Questionnaire (PHQ-9)

  Baseline,Immediately Post-intervention, 2 month follow up, 6 month follow up

• Disability

  Disability will be measured with the Sheehan Disability Scale

  Baseline, Immediately Post-intervention, 2 month follow up, 6 month follow up

Secondary Outcomes (7)

• Anxiety Symptoms

  Baseline, Immediately Post-intervention, 2 month follow up, 6 month follow up

• Physical Health

  Baseline, Immediately Post-intervention, 2 month follow up, 6 month follow up

• Health Service Use

  Baseline, Immediately Post-intervention, 2 month follow up, 6 month follow up

• Recruitment Rates

  Baseline

• Intervention Adherence

  Immediately Post-Intervention

Study Arms (1)

Narrative Exposure Therapy

EXPERIMENTAL

Firefighters will receive distance-delivered NET administered by a paraprofessional.

Behavioral: Distance-delivered NET

Interventions

Distance-delivered NET BEHAVIORAL

One-on-one intervention delivered by a paraprofessional; 12 weekly videoconference sessions at 90 minutes.

Narrative Exposure Therapy

Eligibility Criteria

• Age: 19 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Participants must meet the following criteria to be eligible to move on to Consent
• Be at least 19 years of age
• Be able to understand spoken and written English at a Grade 8 level
• Be employed, or have been employed, by the fire service or be current or past fire service volunteers.
• Fulfill the criteria of full or subclinical PTSD/I according to the PCL-5.
• Have access to a computer with Internet.
• Live in Atlantic Canada or Ontario.
• Consent to be audio- (for consent and interview) and video-recorded (for intervention sessions).

You may not qualify if:

• Having a psychotropic medication change in the past three weeks.
• Are currently engaged in or have previously been engaged in exposure therapy for PTSD/I.
• Meet criteria for current mania or psychosis.
• Endorse suicidal ideation with plan or intent.
• Experience high levels of dissociation (as assessed by a score of \>18.5 on the Shutdown Dissociation Scale).

Sponsors & Collaborators

• IWK Health Centre: lead
• Canadian Institutes of Health Research (CIHR): collaborator
• University of New Brunswick: collaborator

Study Sites (1)

University of New Brunswick

Fredericton, New Brunswick, E3B5A3, Canada

Location

Related Publications (1)

• Olthuis JV, Kaltenbach E, Giberson E, Saryeddine T, Asmundson GJG, Carleton RN, Cramm H, Crombach A, Devlin J, Mack J, Lingley-Pottie P, Rao S, Sullivan M, Wozney L, McGrath PJ. Paraprofessional delivery of online narrative exposure therapy for firefighters. J Trauma Stress. 2023 Aug;36(4):772-784. doi: 10.1002/jts.22941. Epub 2023 Jun 8.

  PMID: 37291963 DERIVED

MeSH Terms

Conditions

Stress Disorders, Post-Traumatic

Condition Hierarchy (Ancestors)

Stress Disorders, Traumatic; Trauma and Stressor Related Disorders; Mental Disorders

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: May 8, 2020
• First Posted: May 13, 2020
• Study Start: June 29, 2020
• Primary Completion: March 31, 2021
• Study Completion: December 31, 2021
• Last Updated: March 31, 2022

Record last verified: 2022-03

Locations

CA (1)