An Augmented Training Program for Preventing Post-Traumatic Stress Injuries Among Diverse Public Safety Personnel

NCT05530642 | Unknown

• 1 other identifier: 2020-226
• Study Type: interventional
• Target: 192
• Locations: 1 country
• Sites: 1

Brief Summary

Public safety personnel (PSP; e.g., border services personnel, correctional workers, firefighters, paramedics, police, public safety communicators) are frequently exposed to potentially psychologically traumatic events. Such events contribute to substantial and growing challenges from posttraumatic stress injuries (PTSIs), including but not limited to posttraumatic stress disorder. The PSP PTSI Study has been designed to evaluate an evidence-informed, proactive system of mental health assessment and training among Royal Canadian Mounted Police (www.rcmpstudy.ca) for delivery among diverse PSP (i.e., firefighters, municipal police, paramedics, public safety communicators). The training is based on the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders, adapted for PSP, and named Emotional Resilience Skills Training (ERST). The subsequent PSP PTSI Study results are expected to benefit the mental health of all participants and, ultimately, all PSP.

Conditions

Posttraumatic Stress Disorder; Major Depressive Disorder; Panic Disorder; Generalized Anxiety Disorder; Trauma; Traumatic Stress Disorder; Trauma and Stressor Related Disorders; Vicarious Trauma

Outcome Measures

Primary Outcomes (8)

• Change in Posttraumatic Stress Disorder Symptoms from Time 1 (pre-training; week 1) to Time 2 (post-training; week 13)

  Posttraumatic Stress Disorder Checklist Version 5; Total scores range from 0 to 80; Higher scores indicate more severe symptoms.

  Time 1 (pre-training; week 1), Time 2 (post-training; week 13)

• Sustained Posttraumatic Stress Disorder Symptoms from Time 2 (post-training; week 13) to Time 3 (1-year follow-up; week 65)

  Posttraumatic Stress Disorder Checklist Version 5; Total scores range from 0 to 80; Higher scores indicate more severe symptoms.

  Time 2 (post-training; week 13), Time 3 (1-year follow-up; week 65)

• Change in Major Depressive Disorder Symptoms from Time 1 (pre-training; week 1) to Time 2 (post-training; week 13)

  Patient Health Questionnaire - 9 (PHQ-9); Total scores range from 0 to 36; Higher scores indicate more severe symptoms.

  Time 1 (pre-training; week 1), Time 2 (post-training; week 13)

• Sustained Major Depressive Disorder Symptoms from Time 2 (post-training; week 13) to Time 3 (1-year follow-up; week 65)

  Patient Health Questionnaire - 9 (PHQ-9); Total scores range from 0 to 36; Higher scores indicate more severe symptoms.

  Time 2 (post-training; week 13), Time 3 (1-year follow-up; week 65)

• Change in Generalized Anxiety Disorder Symptoms from Time 1 (pre-training; week 1) to Time 2 (post-training; week 13)

  Generalized Anxiety Disorder Scale - 7 (GAD-7); Total scores range from 0 to 28; Higher scores indicate more severe symptoms.

  Time 1 (pre-training; week 1), Time 2 (post-training; week 13)

• Sustained Generalized Anxiety Disorder Symptoms from Time 2 (post-training; week 13) to Time 3 (1-year follow-up; week 65)

  Generalized Anxiety Disorder Scale - 7 (GAD-7); Total scores range from 0 to 28; Higher scores indicate more severe symptoms.

  Time 2 (post-training; week 13), Time 3 (1-year follow-up; week 65)

• Change in Panic Disorder Symptoms from Time 1 (pre-training; week 1) to Time 2 (post-training; week 13)

  Panic Disorder Severity Scale (PDSS); Total scores range from 0 to 28; Higher scores indicate more severe symptoms.

  Time 1 (pre-training; week 1), Time 2 (post-training; week 13)

• Sustained Panic Disorder Symptoms from Time 2 (post-training; week 13) to Time 3 (1-year follow-up; week 65)

  Panic Disorder Severity Scale (PDSS); Total scores range from 0 to 28; Higher scores indicate more severe symptoms.

  Time 2 (post-training; week 13), Time 3 (1-year follow-up; week 65)

Study Arms (1)

Emotional Resilience Skills Training (ERST)

EXPERIMENTAL

The Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (UP) is an evidence-based cognitive-behavioral intervention designed to cultivate constructive approach-oriented emotional engagement. The 13-week Emotional Resilience Training (ERST) is an adaptation of the UP designed for use as a proactive training course. The ERST frames emotional experiences as natural responses to threat, rather than pathological occurrences to avoid; as such, the ERST is well-suited for mitigating health challenges and the skills may also help PSP to support persons in distress, including other PSP and the community members they all serve. The ERST training materials include an instructor guide, didactic PowerPoints, and a trainee workbook.

Behavioral: Emotional Resilience Skills Training (ERST)

Interventions

Emotional Resilience Skills Training (ERST) BEHAVIORAL

The ERST training is designed as a "train the trainer" model. Sauer-Zavala, a co-developer of the UP, personally trained a group of PSP trainers from each of the PSP pilot sectors (i.e., CanOps, Regina Fire \& Protective Services, Regina Police Service, Saskatoon Police Service, Regina Emergency Medical Services, Ottawa Emergency Medical Services) during a week-long interactive workshop. The trainers continue to have access to Sauer-Zavala for optional follow-up consultation and support related to delivery of the ERST training for questions or to address any issues that arise during training. Having consultation and support available for the trainers should help to offset concerns raised about ensuring training fidelity subsequent to other mental health programs. Participants have ongoing access to ERST to support skill retention after training is completed, which should help to offset previous indications of problems with skill development for mental health programs.

Also known as: The Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (UP)

Emotional Resilience Skills Training (ERST)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Currently serving PSP firefighters, municipal police officers, paramedics, and public safety communicators
• Potential participants were Canadian citizens or permanent residents
• years or older
• Fluently read, write, and speak either English or French
• Employed in their PSP sector for a minimum of three years
• Access to a computer with internet service

You may not qualify if:

• High risk of suicide or previous suicide attempt/hospitalization within the prior year
• Currently experiencing psychosis, mania
• Currently experiencing impairing drug or alcohol addictions
• Current or ongoing performance management concerns
• Any history of advocating against mental health care

Sponsors & Collaborators

• University of Regina: lead
• Canadian Institutes of Health Research (CIHR): collaborator
• Canadian Institute for Public Safety Research and Treatment: collaborator
• Saskatchewan Ministry of Justice and Attorney General: collaborator
• Association of Public Safety Communication Officials: collaborator
• Frontenac Paramedic Services: collaborator
• Ottawa Paramedic Service: collaborator
• Paramedic Services Chiefs of Saskatchewan: collaborator
• Peterborough County-City Paramedics: collaborator
• Regina Fire and Protective Services: collaborator
• Saskatchewan Association of Chiefs of Police: collaborator
• Saskatchewan Federation of Police Officers: collaborator
• Saskatchewan Health Authority - Regina Area: collaborator

Study Sites (1)

University of Regina

Regina, Saskatchewan, S4S0A2, Canada

Location

Related Publications (4)

• Carleton RN, Kratzig GP, Sauer-Zavala S, Neary JP, Lix LM, Fletcher AJ, Afifi TO, Brunet A, Martin R, Hamelin KS, Teckchandani TA, Jamshidi L, Maguire KQ, Gerhard D, McCarron M, Hoeber O, Jones NA, Stewart SH, Keane TM, Sareen J, Dobson K, Asmundson GJG. The Royal Canadian Mounted Police (RCMP) Study: protocol for a prospective investigation of mental health risk and resilience factors. Health Promot Chronic Dis Prev Can. 2022 Aug;42(8):319-333. doi: 10.24095/hpcdp.42.8.02.

  PMID: 35993603 BACKGROUND

• Nisbet J, Maguire KQ, Teckchandani TA, Shields RE, Andrews KL, Afifi TO, Brunet A, Keane TM, Kratzig GP, MacPhee RS, Martin RR, McCarron MCE, Neary JP, Sauer-Zavala S, Carleton RN. Suicidal Ideation, Planning, and Attempts Changes Among Diverse Canadian Public Safety Personnel After the Emotional Resilience Skills Training. Suicide Life Threat Behav. 2025 Feb;55(1):e13168. doi: 10.1111/sltb.13168.

  PMID: 39927828 DERIVED

• Carleton RN, Sauer-Zavala S, Teckchandani TA, Maguire KQ, Jamshidi L, Shields RE, Afifi TO, Nisbet J, Andrews KL, Stewart SH, Fletcher AJ, Martin R, MacPhee RS, MacDermid JC, Keane TM, Brunet A, McCarron M, Lix LM, Jones NA, Kratzig GP, Neary JP, Anderson G, Ricciardelli R, Cramm H, Sareen J, Asmundson GJG. Mental health disorder symptom changes among public safety personnel after emotional resilience skills training. Compr Psychiatry. 2025 Apr;138:152580. doi: 10.1016/j.comppsych.2025.152580. Epub 2025 Feb 5.

  PMID: 39923735 DERIVED

• Carleton RN, McCarron M, Kratzig GP, Sauer-Zavala S, Neary JP, Lix LM, Fletcher AJ, Camp RD 2nd, Shields RE, Jamshidi L, Nisbet J, Maguire KQ, MacPhee RS, Afifi TO, Jones NA, Martin RR, Sareen J, Brunet A, Beshai S, Anderson GS, Cramm H, MacDermid JC, Ricciardelli R, Rabbani R, Teckchandani TA, Asmundson GJG. Assessing the impact of the Royal Canadian Mounted Police (RCMP) protocol and Emotional Resilience Skills Training (ERST) among diverse public safety personnel. BMC Psychol. 2022 Dec 9;10(1):295. doi: 10.1186/s40359-022-00989-0.

  PMID: 36494748 DERIVED

Related Links

• PSP PTSI Study Website
• RCMP Study Website

MeSH Terms

Conditions

Stress Disorders, Post-Traumatic; Depressive Disorder, Major; Panic Disorder; Generalized Anxiety Disorder; Wounds and Injuries; Stress Disorders, Traumatic; Trauma and Stressor Related Disorders; Compassion Fatigue

Condition Hierarchy (Ancestors)

Mental Disorders; Depressive Disorder; Mood Disorders; Anxiety Disorders; Mental Fatigue; Fatigue; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Behavioral Symptoms; Behavior; Occupational Stress; Stress, Psychological

Study Officials

• R. Nicholas Carleton, PhD

  University of Regina

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: The PSP PTSI Study uses a longitudinal prospective sequential experimental cohort design that engages each participant for approximately 16 months. Several practical constraints prohibited a randomized controlled trial, including resource limitations and probable interactions between PSP during and after training.

Study Record Dates

• First Submitted: August 29, 2022
• First Posted: September 7, 2022
• Study Start: September 22, 2020
• Primary Completion: December 31, 2024
• Study Completion: December 31, 2024
• Last Updated: December 4, 2023

Record last verified: 2023-11

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)