Research

PSPNET Stakeholder Interview Summary

Recent Publications by our Investigators

PSPNET Stakeholder Interview Summary

What did we do?

Public safety personnel (PSP) work hard to keep Canadians safe. PSP have high rates of mental health problems and often struggle to access effective mental health care, such as cognitive behaviour therapy (CBT). The PSPNET team’s mission is to develop and evaluate Internet-delivered cognitive behaviour therapy (ICBT) that is tailored specifically to PSP. ICBT is more accessible than face-to-face CBT and is similarly effective. To inform the development of our program, we conducted and systematically analyzed interviews with PSP. We interviewed 126 PSP from across Saskatchewan and Quebec, including police, fire, EMS, corrections, dispatch, and border services.

What did we find?

PSP shared various reasons why they do not seek face-to-face mental health care. They also shared what they perceived to be the advantages and disadvantages of ICBT.

When asked about the content that should be included, stakeholders listed many options. The top six were:

  • Identifying and understanding symptoms
  • Relationships and Communication 5
  • Improving Sleep
  • Regulating Emotions
  • Substance misuse/dependency
  • Real case stories specific to PSP

When asked what PSP want ICBT therapists to know about them, the top six answers were:

  • They are frequently exposed to potentially traumatic events
  • They have a high frequency of mental and physical health issues with limited workplace support
  • There is an expectation of toughness
  • PSP become pessimistic/jaded over time
  • It is often difficult to talk to other people about their experiences
  • They often tend to have Type A personalities and a high need for control

Where do we go from here?

The interviews indicated that there is strong support for ICBT among PSP. We have used the feedback from these interviews to help tailor ICBT for PSP. PSPNET is now being offered in Saskatchewan with plans underway to offer services in Quebec later in 2020

Stakeholders Interviewed 

Footnotes

  1. No PSP from Quebec responded that PSP would be “unlikely” to use ICBT.
  2. Only one PSP from Saskatchewan mentioned that there are limited or no mental health services available. Instead, Saskatchewan PSP were more likely to identify time constraints and hours of operation of services as barriers to mental health care.
  3. Many PSP felt that mental health services offered specifically to PSP are important because they can lead to improved job performance, which benefits the public.
  4. Concerns about security and concerns about PSP not feeling accountable to complete treatment tasks were expressed less frequently among PSP in Quebec than PSP in Saskatchewan.
  5. PSP from Quebec also suggested that ICBT for PSP should include content related to communicating with and helping colleagues.

Recent Publications by our Investigators

Internet-delivered Cognitive Behaviour Therapy

Titov, N.,  Hadjistavropoulos, H. D.,  Nielssen, O., Mohr, D. C., Andersson, G.,  & Dear, B. F. (2019). From research to practice: Ten lessons in delivering digital mental health services. Journal of Clinical Medicine, 8. doi:10.3390/jcm8081239
Hadjistavropoulos, H.D., Schneider, L. H., Mehta, S., Karin, E., Dear, B. F. & Titov, N. (2019). Preference trial of Internet-delivered cognitive behaviour therapy comparing standard weekly versus optional weekly therapist support. Journal of Anxiety Disorders, 63, 51-60. https://doi.org/10.1016/j.janxdis.2019.02.002  
Mehta, S.,  Peynenburg, V., & Hadjistavropoulos, H. D. (2018).  Internet-delivered cognitive behaviour therapy for chronic health conditions: A systematic review and meta-analysis. Journal of Behavioral Medicine.  
Titov, N., Dear, B,.Nielssen, O.,Staples, L,. Hadjistavropoulos, H,.Nugent, M., Adlam, K.,Nordgreen, T,. Hogstad Bruvik, K., Hovland, A., Repål, A., Mathiaen, K., Kraepelien, M., Blom, K., Svanborg, C., Lindefors, N. & Kaldo, V. (2018). ICBT in routine care: A descriptive analysis of successful clinics in five countries. Internet Interventions, 13, 108-115. https://doi.org/10.1016/j.invent.2018.07.006  
Hadjistavropoulos, H. D., Faller, Y. N., Klatt, A., Nugent, M. N., Dear, B. D., & Titov, N. (2018). Patient perspectives on strengths and challenges of therapist-assisted Internet-delivered cognitive behaviour therapy: using the patient voice to improve care. Community Mental Health Journal, 54, 944-950. https://doi.org/10.1007/s10597-018-0286-0
Hadjistavropoulos, H. D., Schneider, L. H., Klassen, K,, Dear, B. F. & Titov, N. (2018). Development and evaluation of a scale assessing therapist fidelity to guidelines for delivering therapist-assisted Internet-delivered cognitive behaviour therapy. Cognitive Behaviour Therapy, 1-15. https://doi.org/10.1080/16506073.2018.1457079
Edmonds, M., Hadjistavropoulos, H. D, Schneider, L. H, Dear, B. F, & Titov, N. (2018). Who benefits most from therapist-assisted Internet-delivered cognitive behaviour therapy in clinical practice? Predictors of symptom change and drop out. Journal of Anxiety Disorders, 54, 24–32. https://doi.org/10.1016/j.janxdis.2018.01.003
Hadjistavropoulos, H. D., Nugent, M., Dirkse, D., & Pugh, N. (2017). Implementation of Internet-delivered cognitive behavior therapy within community mental health clinics: A process evaluation using the consolidated framework for implementation research. BMC Psychiatry, 17:331.  https://doi.org/10.1186/s12888-017-1496-7
Hadjistavropoulos, H. D., Pugh, N., Hesser, H., & Andersson, G. (2017). Therapeutic alliance in therapist-assisted Internet-delivered cognitive behavior  therapy for depression and anxiety. Clinical Psychology and Psychotherapy, 24, 451-461. https://doi.org/10.1002/cpp.2014
Hadjistavropoulos, H. D., Schneider, L. H., Edmonds, M., Karin, E., Nugent, M. N., Dirkse, D., Dear, B. F., & Titov, N. (2017). Randomized controlled trial of Internet-delivered cognitive behaviour therapy comparing standard weekly versus optional weekly therapist support. Journal of Anxiety Disorders, 52, 15-24. https://doi.org/10.1016/j.janxdis.2017.09.006  
Soucy, J. N., Owens, V. A. M., Hadjistavropoulos, H. D., Dirkse, D. A., & Dear, B. F. (2016). Educating patients about Internet-delivered cognitive behaviour therapy: Perceptions among treatment seekers and non-treatment seekers before and after viewing an educational video. Internet Interventions, 6, 57-63. https://doi.org/10.1016/j.invent.2016.09.003
Hadjistavropoulos, H. D., Nugent, M., Alberts, N., Staples, L., Dear, B., & Titov, N. (2016). Transdiagnostic Internet-delivered cognitive behaviour therapy in Canada: An open trial comparing results of a specialized online clinic and nonspecialized community clinics. Journal of Anxiety Disorders, 42, 19-29. https://doi.org/10.1016/j.janxdis.2016.05.006
Hadjistavropoulos, H. D., Pugh, N., Hesser, H., & Andersson, G. (2016). Predicting response to therapist-assisted Internet-delivered cognitive behaviour therapy for depression of anxiety within an open dissemination trial. Behavior Therapy, 47, 155-165. https://doi.org/10.1016/j.beth.2015.10.006
Hadjistavropoulos, H. D., Alberts, N., Nugent, M., & Marchildon, G. (2014). Improving access to psychological services through therapist-assisted, Internet-delivered cognitive behaviour therapy. Canadian Psychology, 55, 303-311 https://dx.doi.org/10.1037/a0037716
Hadjistavropoulos, H. D., Pugh, N. E., Nugent, M., Hesser, H., Andersson, G., Marchildon, G. P., et al. (2014).Therapist-assisted Internet-delivered cognitive behaviour therapy for depression and anxiety: Translating evidence into clinical practice. Journal of Anxiety Disorders, 28, 884-893. http://doi.org/10.1016/j.janxdis.2014.09.018
Hadjistavropoulos, H. D., Thompson, M., Klein, B., & Austin, D. (2012). Dissemination of therapist-assisted Internet Cognitive Behaviour Therapy: Development and open pilot study of a workshop. Cognitive Behaviour Therapy, 40, 230-240. https://doi.org/10.1080/16506073.2011.645550
Hadjistavropoulos, H. D., Thompson, T., Ivanov, M., Drost, C., Butz, C., Klein, B., & Austin, D. (2011). Considerations in the development of a therapist-assisted internet cognitive behavior therapy service. Professional Psychology: Research and Practice, 42, 463-471. https://doi.org/10.1080.16506073.2018.1457079

Mental Health for Public Safety Personnel

 
Carleton, R. N., Afifi, T. O., Turner, S., Taillieu, T., Vaughan, A. D., Anderson, G. S., Ricciardelli, R., MacPhee, R. S., Cramm, H. A., Czarnuch, S., Hozempa, K., & Camp, R. D. II. (2019). Mental Health Training, Attitudes Towards Support, and Screening Positive for Mental Disorders. Cognitive Behaviour Therapy, 43, 374-386. doi: 10.1080/16506073.2019.1575900  
Carleton, R. N., Afifi, T. O., Taillieu, T., Turner, S., El-Gabalawy, R., Sareen, J., & Asmundson, G. J. G. (2018). Anxiety-related psychopathology and chronic pain comorbidity among public safety personnel. Journal of Anxiety Disorders, 55, 48-55. doi: 10.1016/j.janxdis.2018.03.006
Carleton, R. N, Afifi, T. O., Turner, S., Tallieu, T., Duranceau, S., LeBouthillier, D. M., Sareen, J., Ricciardelli, R., MacPhee, R., Groll, D., Hozempa, K., Brunet, A., Weekes, J. R., Griffiths, C. T., Abrams, K. J., Jones, N. A., Beshai, S., Cramm, H. A., Dobson, K. S., Hatcher, S., Keane, T. M., Stewart, S. H., & Asmundson, G. J. G. (2017). Mental disorder symptoms among public safety personnel in Canada. Canadian Journal of Psychiatry, 63(1), 54-64. doi: 10.1177/0706743717723825  
Carleton, R. N., Afifi, T. O., Turner, S., Taillieu, T., LeBouthillier, D. M., Duranceau, S., Sareen, J., Ricciardelli, R., MacPhee, R. S., Groll, D., Hozempa, K., Brunet, A., Weekes, J. R., Griffiths, C. T., Abrams, K. J., Jones, N. A., Beshai, S., Cramm, H. A., Dobson, K. S., Hatcher, S., Keane, T. M., Stewart, S. H., & Asmundson, G. J. G. (2018). Suicidal ideation, plans, and attempts among public safety personnel in Canada. Canadian Psychology/Psychologie canadienne, 59(3), 220-231. doi: 10.1037/cap0000136  
Ricciardelli, R., Carleton, R. N., Mooney, T., & Cramm, H. (2018). Playing the system: Structural factors potentiating mental health stigma, challenging awareness, and creating barriers to care for Canadian public safety personnel. Health. doi:10.1177/1363459318800167  
Ricciardelli, R., Carleton, R. N., Groll, D., & Cramm, H. (2018). Qualitatively unpacking Canadian public safety personnel experiences of trauma and their well-being. Canadian Journal of Criminology and Criminal Justice, 60(4), 566-577. doi: 10.3138/cjccj.2017-0053.r2
Turner, S., Taillieu, T., Carleton, R. N., Sareen, J., & Afifi, T. (2018). Association between a history of child abuse and suicidal ideation, plans and attempts among Canadian public safety personnel: A cross-sectional survey. Canadian Medical Association Journal Open, 6(4), E463-E470. doi:10.9778/cmajo.20170153  
Beshai, S., & Carleton, R. N. (2016). Peer support and crisis-focused psychological intervention programs in Canadian first responders: Blue Paper. Regina, SK: University of Regina Collaborative Centre for Justice and Safety. Available from: http://www.justiceandsafety.ca/rsu_docs/blue_paper_full_web_final_production_aug_16_2016.pdf