Exploring Perceptions of Internet-Delivered Cognitive Behaviour Therapy among Public Safety Personnel: Informing Dissemination Efforts

Abstract

Background Public safety personnel (PSP) experience high rates of mental health disorders but have limited access to treatment. To improve treatment access, there is a growing interest in offering internet-delivered cognitive behaviour therapy (ICBT) to PSP. As attitudes towards ICBT can both impact and inform ICBT implementation efforts, this study examines perceptions of ICBT among PSP who viewed a poster (a commonly used method of advertising ICBT) or a poster supplemented with a story of a PSP who benefitted from ICBT. Methods Participants (N = 132) from various PSP sectors were randomly assigned to view a poster or a poster and a story. Participants then completed an online survey assessing their perceptions of ICBT using both qualitative and quantitative questions. We used a mixed-methods approach to analyze the data. Results No differences in perceptions of ICBT were identified between the conditions. Ratings of credibility, treatment expectancy, anticipated treatment adherence, and acceptability suggested that PSP had positive perceptions of ICBT. Most participants (93%) reported that they would access ICBT if they needed help with mental health concerns. Participants ranked therapist-guided ICBT as their second most preferred treatment, with psychologists ranked first. Female participants found ICBT more credible than male participants. More experienced PSP reported lower acceptability and anticipated adherence to ICBT. Conclusions The findings suggest that many PSP are likely to be receptive to ICBT even when a simple poster is used as a method of informing PSP of this treatment option. Further attention to improving the perceptions of ICBT among certain groups may be warranted.

Initial Outcomes of Transdiagnostic Internet-Delivered Cognitive Behavioral Therapy Tailored to Public Safety Personnel: Longitudinal Observational Study

“…The course is designed to be completed in 8 weeks, but clients are provided with therapist support for up to 16 weeks based on symptoms and preference, and are given access to the course materials for 1 year. We tailored the PSP Wellbeing Course using extensive feedback from PSP stakeholders gleaned through 112 interviews [ 15 ] and 132 survey responses [ 23 ] (eg, replacing generic case stories and examples used to illustrate treatment concepts with case stories and examples about PSP).…”

“…Tailoring ICBT may be particularly important for PSP, who have reported several unique needs such as the need for flexible treatment timelines, diverse preferences for frequency of therapist support, specialized therapists with knowledge of unique PSP issues and culture, and a focus on exposures to potentially psychologically traumatic events [ 15 ]. Canadian PSP appear receptive to therapist-supported ICBT, which was ranked as their most preferred mental health treatment after face-to-face psychological services [ 23 ].…”

How Have Public Safety Personnel Seeking Digital Mental Healthcare Been Affected by the COVID-19 Pandemic? An Exploratory Mixed Methods Study

“…Internet-delivered cognitive behavioral therapy (ICBT) is private, accessible at virtually any time and location, and cost-effective [ 25 , 26 ], which can help PSP overcome most barriers. Indeed, research shows that PSP report favorable attitudes towards ICBT [ 23 , 27 ]. Our research unit, PSPNET, launched a free-to-access ICBT program for PSP in the Canadian province of Saskatchewan in January 2020, which was shortly before the COVID-19 pandemic reached Saskatchewan.…”

Why Do Public Safety Personnel Seek Tailored Internet-Delivered Cognitive Behavioural Therapy? An Observational Study of Treatment-Seekers

“…Men and women were approximately equally represented in the current sample. Most Canadian PSP are men, but past research suggests that PSP women experience higher rates of mental health disorders than PSP men [4], and women report more favorable attitudes toward ICBT [27]; as such, the relatively even representation of men and women was unsurprising. The underrepresentation of PSP from Quebec is due, at least in part, to the fact that PSPNET first began offering services in Saskatchewan.…”

“…However, many implementation efforts have been hindered by issues such as high attrition rates, lack of consensus concerning the necessary standards of evidence to support wider implementation, and problems with study designs [26]. PSP have reported favorable attitudes towards ICBT, describing the privacy and convenience it affords as particular advantages [12,27]. Our research unit, PSPNET, has developed a transdiagnostic ICBT program tailored specifically for Canadian PSP, in keeping with recommendations to tailor digital mental health interventions towards specific user groups (e.g., [28,29]).…”