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Completed

NCT Number: NCT04386330

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

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.

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Key information

Age range

19 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University of New Brunswick

Fredericton, New Brunswick, E3B5A3, Canada

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

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).

Exclusion criteria

  • 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).

Treatment and study plan

Distance-delivered NET

Behavioral

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

Primary outcomes

  1. Change in PTSD/I symptoms

    Time frame: Baseline, Immediately Post- intervention, 2 month follow up, 6 month follow up

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

  2. Change in depressive symptoms

    Time frame: Baseline,Immediately Post-intervention, 2 month follow up, 6 month follow up

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

  3. Disability

    Time frame: Baseline, Immediately Post-intervention, 2 month follow up, 6 month follow up

    Disability will be measured with the Sheehan Disability Scale

Secondary outcomes

  1. Anxiety Symptoms

    Time frame: Baseline, Immediately Post-intervention, 2 month follow up, 6 month follow up

    Anxiety symptoms will be measured using the Generalized Anxiety Disorder - 7 item (GAD-7)

  2. Physical Health

    Time frame: Baseline, Immediately Post-intervention, 2 month follow up, 6 month follow up

    Physical health will be measured with the Patient Health Questionnaire Physical Symptoms (PHQ-15)

  3. Health Service Use

    Time frame: Baseline, Immediately Post-intervention, 2 month follow up, 6 month follow up

    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

  4. Recruitment Rates

    Time frame: Baseline

    Recruitment rates will be tracked by research staff throughout the study

  5. Intervention Adherence

    Time frame: Immediately Post-Intervention

    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.

  6. Coach Alliance

    Time frame: Immediately Post-Intervention

    Coach alliance will be measured using the Working Alliance Inventory - Short Form Revised (WAI-SR)

  7. Intervention Perceptions and Satisfaction

    Time frame: Immediately Post-Intervention

    Intervention perceptions and satisfaction will be measured via open-ended questions administered through a post-intervention interview

Sponsors and collaborators

Lead sponsor

IWK Health Centre

Other

Collaborators

  • Canadian Institutes of Health Research (CIHR)
  • University of New Brunswick

Registry information

Official study title

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

Important dates

Study start
2020
Primary completion
2021
Study completion
2021
First posted
May 13, 2020
Registry last updated
Mar 31, 2022

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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