A Longitudinal RCT on the Effectiveness of a Psychological Intervention for Hospital Healthcare Workers During the COVID-19 Pandemic: What We Learned to Date

Abstract

The COVID-19 pandemic has led to significant psychological distress among frontline healthcare workers (HCWs), with a particular increase in trauma-related symptoms. This study investigated the longitudinal course of trauma-associated symptoms and behaviors in HCWs and the effectiveness of a brief dialectical behavior therapy (DBT)-informed intervention in mitigating these symptoms over 12 months. The trial included 225 HCWs randomly assigned to one of three groups: no intervention (control), in-person DBT-informed intervention, or online DBT-informed intervention. Over time, a natural decrease in PTSD symptoms was observed in all groups. Contrary to expectations, no difference was found between the control and intervention groups. However, for participants with severe PTSD symptoms, the intervention significantly mitigated their distress. No differences emerged between in-person and online interventions, suggesting equal effectiveness. Females reported higher trauma-related symptoms, while no differences emerged among different professional roles. These findings underscore the importance of targeted interventions for HCWs experiencing severe symptoms and highlight the potential of online modalities. Further research is needed to optimize the deployment of mental health resources within the healthcare setting, particularly during crises.

Mapping the needs of healthcare workers caring for COVID-19 patients using the socio-ecological framework: a rapid scoping review

“…lower occupational stress and anxiety vs. CG at post-treatment Otared et al [ 48 ] Iran RCT 40 Healthcare workers (100%) Tabriz Group 8 ACT Waitlist • IG sign. lower depression and anxiety and higher quality of life vs. CG at post-treatment Rizzi et al [ 57 ] Italy RCT 225 Nurse: 92 (41.0%) Doctor: 90 (40.0%) Pavia in-person or online individual NR Brief DBT No intervention • Sign. decrease in PTSD symptoms in all groups across time • No sign.…”

“…Interventions were mostly compared to a control group ( n = 12, 85.7%), such as a waitlist or no-intervention control ( n = 6 out of 12, 50.0%). In six studies (33.3%), individuals received a group psychological intervention with other HCWs [ 46 – 51 ], whereas in six studies (33.3%), individuals received 1:1 online or telephone counseling from a therapist [ 52 – 57 ]. Interventions were also delivered digitally through developed applications ( n = , 16.7%) [ 58 – 60 ] including written and audiovisual psychological exercises (e.g., mindfulness, CBT techniques), a developed platform [ 61 ] with videos, interactive exercises with written information, a developed website [ 62 ] with psychoeducational videos and exercises and a web-based stress management intervention [ 63 ] based on ACT as developed by WHO including audiorecordings and illustrated exercises.…”

“… The French website “My Health too” (an online CBT intervention) [ 62 ] was reported as feasible, acceptable and useful in inducing relaxation and for practicing self-compassion in HCWs who faced high levels of stress. A brief intervention on Dialectical Behavior Therapy (DBT) [ 57 ] resulted in reductions in post-traumatic disorder symptoms compared to the no-intervention control group, but only in participants with severe symptomatology. The RECHARGE online intervention (strategies on problem solving, relapse prevention in stressful situations) [ 56 ] led to greater reduction in distress, worry, and burnout than active treatment-as-usual group at post-treatment.…”

“…A brief intervention on Dialectical Behavior Therapy (DBT) [ 57 ] resulted in reductions in post-traumatic disorder symptoms compared to the no-intervention control group, but only in participants with severe symptomatology.…”