Randomized Controlled Trial: Self-Care Traumatic Episode Protocol, Computerized EMDR Treatment of COVID-19-Related Stress

Abstract

Healthcare workers and Mental Health clinicians are at heightened risk for mental health issues while they support their communities during the COVID-19 pandemic, and early psychological intervention is crucial to protect them. The Self-Care Traumatic Episode Protocol (STEP) is a computerized intervention adapted from the Eye Movement Desensitization and Reprocessing Group Traumatic Episode Protocol (EMDR G-TEP). This study evaluated the effectiveness of STEP for Mental Health clinicians in the context of COVID-19. Thirty-four Mental Health clinicians were randomly allocated to treatment (n = 17) or waitlist (n = 17). The Generalized Self-Efficacy Scale (GSE) and Depression and Anxiety Stress Scale (DASS- 21) were completed by the treatment group at baseline and 1-week follow-up postintervention and by the waitlist group at baseline, preintervention, and 1-week follow-up postwaitlist. Pre–post comparisons showed a significant decrease in depression, anxiety, and stress for Immediate Treatment, t(15) = −3.64, p < .01, d = .73, and for Delayed Treatment, t(15) = −3.53, p < .01, d = .68, There was also a significant increase in general self-efficacy for Immediate Treatment, t(15) = 2.87, p < .05, d = .46, and Delayed Treatment, t(15) = 3.72, p < .01, d = .56. The randomized controlled trial (RCT) indicated that STEP may be effective in increasing general self-efficacy and reducing symptoms of depression, anxiety, and stress among Mental Health clinicians in the context of COVID-19. Further research investigating the potential of utilizing the STEP intervention on a larger scale and with other populations is needed.

Low-Intensity Interventions and EMDR Therapy

“…This statement is appropriate, given the fact that until now, only one single self-administered EMDR treatment had been tested in research (Spence et al, 2013). Even though there are now two additional published studies (Karadag et al, 2021;Moench & Billsten, 2021), these provide only very preliminary evidence. They are suggestive of the possibility that effective safe EMDR self-help treatments can be developed.…”

“…Can safe self-help computerized EMDR treatments for mild/moderate PTSD be developed that draw on the procedures used in group treatment? Moench and Billsten (2021) stated that they are working on developing other versions of their computerized EMDR treatment, STEP, that may make it available for other populations. It is recommended that they add asynchronous therapist guidance to make the program more accessible and to enhance retention for clients with mild/moderate PTSD.…”

“…Therapist monitoring ensures that the client is receiving appropriate care and responding as expected, or if the client should be referred for highintensity individual treatment. Other safety strategies include the embedding of stop-measures in computerized programs, such as was done in the EMDR computerized program of Moench and Billsten (2021).…”

“…Some new single-session EMDR group protocols have been developed for remote access (e.g., on HIPAA platforms) and proven effective in RCTs (e.g., Becker et al, 2021;Johanson et al, 2021;Smyth-Dent et al, 2021). Another RCT showed successful use of a computerized format of a group treatment (Moench & Billsten, 2021). It is described in the following section.…”

“…Moench (2020) created a computerized self-help version of G-TEP, called the Self Care Traumatic Episode Protocol (STEP), in consultation with Elan Shapiro, developer of G-TEP (E. Shapiro & Moench, 2015). STEP was evaluated in an RCT (Moench & Billsten, 2021), which compared immediate treatment to waitlist/delayed treatment for 33 mental health clinicians impacted by COVD-19. Results showed significant improvements on the Depression and Anxiety Stress Scale (with large effect size) and the Generalized Self-Efficacy Scale (with moderate effect size).…”