Digitalizing a Brief Intervention to Reduce Intrusive Memories of Psychological Trauma: Qualitative Interview Study (Preprint)

Abstract

BACKGROUND The COVID-19 pandemic has escalated the global need for remotely-delivered and scalable interventions after psychological trauma. A brief intervention involving a computer game as an imagery-competing task has shown promising results for reducing the number of intrusive memories of trauma—a core clinical symptom of posttraumatic stress disorder. To date, the intervention has only been delivered face-to-face. To be tested and implemented on a wider scale, digital adaptation for remote delivery is crucial. An important first step is to develop digitalised intervention materials in a systematic way based on feedback from clinicians, researchers and students, in preparation for pilot-testing with target-users. OBJECTIVE Our first aim was to obtain and analyse qualitative feedback on the digital intervention materials, namely two animated videos and two quizzes that (i) explain the target clinical symptom, and (ii) provide intervention instructions. The second aim was to refine the digitalised materials based on this feedback. METHODS We carried out semi-structured interviews with 12 participants who had experience delivering or had knowledge of the intervention when delivered face-to-face. We obtained in-depth feedback on perceived feasibility of using the digitalised materials and suggestions for improvements. Interviews were assessed using qualitative content analysis, and suggested improvements evaluated for implementation using a systematic method of prioritisation. RESULTS Three overarching themes were identified from the data. First, participants were highly positive about the potential benefits of using these digital materials for remote delivery, reporting that the videos effectively conveyed key concepts of the symptom and its treatment. Second, some modifications to the materials were suggested for improving clarity; based on this feedback we made nine specific changes. Finally, participants raised some key challenges for remote delivery, mainly in overcoming the lack of real-time communication during the intervention. CONCLUSIONS Clinicians, researchers and clinical psychology students were overall confident in the use of digitalised materials to remotely deliver a brief intervention to reduce intrusive memories of trauma. Guided by participant feedback, we identified and implemented changes to refine the intervention materials. This study lays the groundwork for the next step: pilot-testing remote delivery of the full intervention to trauma survivors.

Reducing intrusive memories after trauma via a brief cognitive task intervention in the hospital emergency department: an exploratory pilot randomised controlled trial

“…In response to informal enquiries from ED staff about using the intervention to address their own intrusive memories of trauma, during the pandemic we developed a new study to evaluate the impact of the intervention for frontline healthcare workers (CTR: NCT04460014) 45-47 e.g., for intrusive memories as a result of work with critically ill/dying COVID-19 patients in intensive care. This follow-up RCT builds on this pilot trial and the intervention procedures piloted here, however it uses remote delivery (i.e., digitally rather than in person, using instructional videos 48 and remote researcher support) due to COVID-19 infection risk. The design and sample size estimation are guided by the between-group effect size in the current pilot findings.…”