Objective: This 2-study longitudinal investigation examined the indirect effects of secondary traumatic stress (STS) on secondary traumatic growth via two mediators: perceived social support and secondary trauma self-efficacy. In particular, we tested if the 2 hypothetical mediators operate sequentially, that is, with secondary trauma self-efficacy facilitating social support (i.e., cultivation hypothesis) and/or social support enhancing self-efficacy (i.e., enabling hypothesis). Method: Participants in Results: In both studies, multiple mediational analyses showed evidence for the cultivation hypothesis. The relationship between STS at Time 1 and secondary traumatic growth at Time 2 was mediated sequentially by secondary trauma self-efficacy at Time 1 and social support at Time 2. The enabling hypothesis was not supported. Conclusion: Education and development programs for healthcare workers may benefit from boosting self-efficacy with the intent to facilitate perceived social support.
Background: Although the evidence for the associations among self-efficacy, secondary traumatic stress (STS) and secondary posttraumatic growth (SPTG) is mounting, there is a lack of the experimental evidence for the influence of self-efficacy on positive and negative mental health outcomes among professionals indirectly exposed to trauma.Purpose: This study investigated the effects of an internet-based self-efficacy intervention (the experimental condition), compared to an education (the active control condition) on STS and SPTG among workers exposed to traumatic events indirectly, through their clients. We hypothesized that the group assignment (experimental vs. control) would affect STS and SPTG indirectly, with a mediating role of self-efficacy beliefs.Methods: Participants were 168 health and human services professionals (78% women), exposed indirectly to a traumatic event at work. They were randomly assigned to either a 4-session internet-based self-efficacy intervention (n = 87) or an education control group (n = 81) which received information about coping resources and consequences of stressors at work or at home. STS, SPTG, and self-efficacy were measured at the baseline (Time 1), 1-month follow-up (Time 2) and 2-month follow-up (Time 3).Results: Analysis of covariance showed that the group assignment had a significant effect on STS (Time 2) and self-efficacy (Time 2), with lower STS and higher self-efficacy reported by the self-efficacy intervention participants. Compared to the experimental group, the active control (education) group participants reported higher SPTG at Time 2. Mediation analyses indicated that the group assignment had indirect effects on STS and SPTG at Time 3. Workers who experienced increases in self-efficacy (Time 2) through the intervention were more likely to report lower STS and higher SPTG at Time 3.Conclusion: Elucidating the mediating processes that explain why an intervention for secondary trauma works is essential in order to develop more effective support systems that promote improved mental health outcomes among health and human services professionals. Prevention programs for workers exposed indirectly to traumatic events may target self-efficacy enhancement and education.
Background Blended treatments, combining digital components with face-to-face (FTF) therapy, are starting to find their way into mental health care. Knowledge on how blended treatments should be set up is, however, still limited. To further explore and optimize blended treatment protocols, it is important to obtain a full picture of what actually happens during treatments when applied in routine mental health care. Objective The aims of this study were to gain insight into the usage of the different components of a blended cognitive behavioral therapy (bCBT) for depression and reflect on actual engagement as compared with intended application, compare bCBT usage between primary and specialized care, and explore different usage patterns. Methods Data used were collected from participants of the European Comparative Effectiveness Research on Internet-Based Depression Treatment project, a European multisite randomized controlled trial comparing bCBT with regular care for depression. Patients were recruited in primary and specialized routine mental health care settings between February 2015 and December 2017. Analyses were performed on the group of participants allocated to the bCBT condition who made use of the Moodbuster platform and for whom data from all blended components were available (n=200). Included patients were from Germany, Poland, the Netherlands, and France; 64.5% (129/200) were female and the average age was 42 years (range 18-74 years). Results Overall, there was a large variability in the usage of the blended treatment. A clear distinction between care settings was observed, with longer treatment duration and more FTF sessions in specialized care and a more active and intensive usage of the Web-based component by the patients in primary care. Of the patients who started the bCBT, 89.5% (179/200) also continued with this treatment format. Treatment preference, educational level, and the number of comorbid disorders were associated with bCBT engagement. Conclusions Blended treatments can be applied to a group of patients being treated for depression in routine mental health care. Rather than striving for an optimal blend, a more personalized blended care approach seems to be the most suitable. The next step is to gain more insight into the clinical and cost-effectiveness of blended treatments and to further facilitate uptake in routine mental health care.
Trauma, Health, and Hazards Center / Centrum Badań nad Traumą, Zdrowiem i Zagrożeniami Streszczenie Wstęp: Celem badania było sprawdzenie efektywności interwencji internetowej "Stres Pomagających" w obniżaniu wypalenia zawodowego i wzmacnianiu zaangażowania w pracę u osób pracujących zawodowo z ofiarami traumy. Materiał i metody: Osoby badane były losowo przypisywane do jednego z 3 modułów interwencji: 1 -wzmacniającego przekonania o własnej skuteczności (N = 87), 2 -wzmacniającego spostrzegane wsparcie społeczne (N = 85) i 3 -edukacyjnego (grupa porównawcza, N = 81). Badani wypełniali internetowe kwestionariusze -przed interwencją (T1), tuż po interwencji (T2) i 4 tygodnie po zakończeniu interwencji (T3). Wyniki: Z uwagi na wysoki odsetek osób, które nie wypełniły kwestionariuszy w T2 i T3 (tzw. drop-out) w module wzmacniającym spostrzegane wsparcie społeczne, z analiz wykluczono pochodzące od nich dane. U osób przypisanych do modułu wzmacniającego przekonania o własnej skuteczności stwierdzono wyższy poziom przekonań o własnej skuteczności w porównaniu z osobami przypisanymi do modułu edukacyjnego zaraz po zakończeniu interwencji (T2) i 4 tygodnie później (T3). Wśród uczestników obu wspomnianych modułów wypalenie zawodowe zmalało istotnie między T1 a T2 oraz między T2 a T3, a zaangażowanie w pracę wzrosło istotnie między T1 a T2 oraz między T1 a T3. Przekonania o własnej skuteczności (T2) pełni-ły funkcję mediatora między rodzajem modułu interwencyjnego (edukacyjny vs wzmacniający przekonania o własnej skuteczności) a odpowiednio: wypaleniem zawodowym (T3) i zaangażowaniem w pracę (T3). Wnioski: Wyniki badania wskazują na mediacyjną rolę przekonań o własnej skuteczności w zmniejszaniu wypalenia zawodowego i wzmacnianiu zaangażowania w pracę. Med. Pr. 2016;67(2):223-237 Słowa kluczowe: wypalenie zawodowe, zaangażowanie w pracę, interwencja internetowa, pośrednia ekspozycja na traumę, przekonania o własnej skuteczności, psychologia zdrowia w pracy Abstract Background: The study aimed at evaluating effectiveness of the web-based intervention, "The Helpers' Stress," in reducing job burnout and enhancing work engagement among professionals working with trauma survivors. Material and Methods: Participants were randomly allocated to 1 of the 3 intervention modules: 1 -the self-efficacy enhancement (N = 87), 2 -the social support enhancement (N = 85), or to 3 -the educational module (comparison group, N = 81). Participants completed the online questionnaires before the intervention (T1), immediately after (T2), and 4 weeks after the intervention (T3). Results: Due to high drop-out rate at T2 and T3 in social support enhancement module, we excluded from analysis participants assigned to this condition. Participants assigned to the self-efficacy enhancement module presented higher levels of self-efficacy (at T2 and T3), compared to those assigned to the educational module. Job burnout decreased significantly between T1 and T2, and between T2 and T3, and work engagement increased significantly between T1 and T2, and betw...
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