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

Post Traumatic Stress Disorder Clinical Trial

Official title:

Firefighters Accessing Care for Trauma: A Clinical Case Series Testing the Efficacy of Distance-Delivered Narrative Exposure Therapy in Reducing PTSD/I Symptoms

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04386330
• Other study ID #: 22081
• Status: Completed
• Phase: N/A
• Start date: June 29, 2020
• Est. completion date: December 31, 2021

Study information

• Verified date: March 2022
• Source: IWK Health Centre
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial 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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 19
• Est. completion date: December 31, 2021
• Est. primary completion date: March 31, 2021
• Accepts healthy volunteers: No
• Gender: All
• Age group: 19 Years and older

Eligibility

Inclusion Criteria:

Participants must meet the following criteria to be eligible to move on to Consent

1. Be at least 19 years of age

2. Be able to understand spoken and written English at a Grade 8 level

3. Be employed, or have been employed, by the fire service or be current or past fire service volunteers.

4. Fulfill the criteria of full or subclinical PTSD/I according to the PCL-5.

5. Have access to a computer with Internet.

6. Live in Atlantic Canada or Ontario.

7. Consent to be audio- (for consent and interview) and video-recorded (for intervention sessions).

Exclusion Criteria:

1. Having a psychotropic medication change in the past three weeks.

2. Are currently engaged in or have previously been engaged in exposure therapy for PTSD/I.

3. Meet criteria for current mania or psychosis.

4. Endorse suicidal ideation with plan or intent.

5. Experience high levels of dissociation (as assessed by a score of >18.5 on the Shutdown Dissociation Scale).

Related Conditions & MeSH terms

• Post Traumatic Stress Disorder
• Post Traumatic Stress Injury
• Stress Disorders, Post-Traumatic
• Stress Disorders, Traumatic

Intervention

Behavioral:
• Distance-delivered NET
One-on-one intervention delivered by a paraprofessional; 12 weekly videoconference sessions at 90 minutes.

Locations

Country	Name	City	State
Canada	University of New Brunswick	Fredericton	New Brunswick

Sponsors (3)

Lead Sponsor	Collaborator
IWK Health Centre	Canadian Institutes of Health Research (CIHR), University of New Brunswick

Country where clinical trial is conducted

Canada, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	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
Primary	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
Primary	Disability	Disability will be measured with the Sheehan Disability Scale	Baseline, Immediately Post-intervention, 2 month follow up, 6 month follow up
Secondary	Anxiety Symptoms	Anxiety symptoms will be measured using the Generalized Anxiety Disorder - 7 item (GAD-7)	Baseline, Immediately Post-intervention, 2 month follow up, 6 month follow up
Secondary	Physical Health	Physical health will be measured with the Patient Health Questionnaire Physical Symptoms (PHQ-15)	Baseline, Immediately Post-intervention, 2 month follow up, 6 month follow up
Secondary	Health Service Use	Health service use will be measured using a series of questions regarding participant's use of health services as well as frequency and intensity of service use	Baseline, Immediately Post-intervention, 2 month follow up, 6 month follow up
Secondary	Recruitment Rates	Recruitment rates will be tracked by research staff throughout the study	Baseline
Secondary	Intervention Adherence	Intervention adherence will be measured via attendance records of participants kept by their coach. These attendance records will be used to measure the average number of completed sessions and the percentage of participants who did not complete the intervention.	Immediately Post-Intervention
Secondary	Coach Alliance	Coach alliance will be measured using the Working Alliance Inventory - Short Form Revised (WAI-SR)	Immediately Post-Intervention
Secondary	Intervention Perceptions and Satisfaction	Intervention perceptions and satisfaction will be measured via open-ended questions administered through a post-intervention interview	Immediately Post-Intervention