Insights into internet-delivered cognitive behavioural therapy for public safety personnel: Exploration of client experiences during and after treatment

Why Was the Study Done?

Canadian public safety personnel (PSP) have high rates of mental health problems. Internet-delivered cognitive behavioural therapy (ICBT) is effective for treating various mental health concerns and can reduce barriers to care like time constraints and fear of stigma. The PSP Wellbeing Course is an ICBT course that has been tailored by PSPNET to the Canadian PSP experience. It includes five core lessons and resources on additional topics. Therapist support is provided weekly, biweekly, or as needed based on client choice over eight weeks with the option to extend to up to 16 weeks.

Tailoring of PSPNET courses is an ongoing process based on feedback from clients sought throughout their time in the courses. The current study looked at data collected from early users of the PSP Wellbeing Course that was used to continue the customization process. The research team wanted to determine the perceived impact of the course as well as what users liked and disliked.

What Was Done in the Study?

This study examined client communication and feedback from 82 clients who signed up for the PSP Wellbeing Course between December 2019 and June 2020.  The study looked at de-identified responses from client emails to therapists, optional weekly homework reflection questions, and a treatment satisfaction questionnaire (TSQ) administered at eight weeks post-enrollment. Of the 82 clients, 57 completed the TSQ.

What Did We Find Out?

1. Of the 57 clients who completed the TSQ, 97% indicated the course was worth their time, and 98% said they would recommend it to others.
2. A majority of clients who completed the TSQ also provided specific comments about benefiting from the course, including:
   • Increased skills and/or improved wellbeing;
   • Normalization of mental health issues;
   • Improved communications or relationships;
   • Beneficial for PSP; and,
   • Good reminder of previously learned skills.
3. Less than 10% of clients who completed the TSQ reported the course had little or no impact on wellbeing.
   • 9% reported the program did not meet their specific needs.
4. Some clients (74%) reported difficultly with the eight-week timeline or technical difficulties logging in or using the course. However, these clients did not report that hindering events were detrimental to their overall experience in the course.
5. 25% of clients that completed the course indicated they had experienced an increase or novel symptoms from working on the course. However, they also indicated that the course skills helped them cope with these changes and the effects decreased as they progressed through the course.
6. Thought-challenging was the skill most frequently cited as helpful.
7. Clients reported several helpful aspects of the course including:
   • Therapist check-ins and communication;
   • Course design and format;
   • DIY guides;
   • PSP stories;
   • Additional resources beyond the core lessons; and,
   • Flexibility and convenience of the course.
8. When asked to provide suggestions for improving the course, clients suggested:
   • Improving some aspects of the course design and materials;
   • Improving some of the case stories;
   • Including more topics in the additional resources;
   • Including audio/video;
   • Adjusting the course timelines;
   • Addressing technical issues; and,
   • Increasing contact or accountability.

Where Do We Go From Here?

PSPNET has been designed to fill a need for tailored and easily accessible mental health treatment for PSP. Feedback from clients allows for continued program improvement. The feedback outlined in this study was used to make improvements to the PSP Wellbeing Course, including adding and improving additional resources and the inclusion of lesson audio. The course is now offered to all PSP in Saskatchewan, Quebec, New Brunswick, and Nova Scotia at no charge.

The original wording of the study was changed and condensed for the current research summary.

Read the full article

Original study:

Beahm, J., McCall, H., Carleton, R. N., Titov, N., Dear, B., Hadjistavropoulos, H. (2021). Insights into internet-delivered cognitive behavioural therapy for public safety personnel: Exploration of client experiences during and after treatment. Internet Interventions, 26, 100481. https://doi.org/10.1016/j.invent.2021.100481.

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