Understanding and Addressing Occupational Stressors in Internet-Delivered Therapy for Public Safety Personnel: A Qualitative Analysis

Abstract

Internet-delivered cognitive behavioral therapy (ICBT) is effective when tailored to meet the needs of public safety personnel (PSP). Nevertheless, there is limited research on the nature of the occupational stressors faced by PSP who seek ICBT and how PSP use ICBT to address occupational stressors. We provided tailored ICBT to PSP (N = 126; 54% women) and conducted a qualitative content analysis on clinicians’ eligibility screening notes, clients’ emails, and clients’ survey responses to understand the occupational stressors faced by PSP and their use of ICBT to address such stressors. Clients described several occupational stressors, including operational stressors (e.g., potentially psychologically traumatic events and sleep/shiftwork issues) and organizational stressors (e.g., issues with leadership, resources, and workload). More clients shared occupational concerns during the screening process (97%) than during treatment (58%). The most frequently cited occupational stressor was exposure to potentially psychologically traumatic events. Clients reported using course skills (e.g., controlled breathing and graduated exposure) to manage occupational stressors (e.g., responding to calls, workplace conflict, and work–family conflict). Thought challenging was the most frequently reported strategy used to manage occupational stressors. The current results provide insights into the occupational stressors PSP experience and endeavor to manage using ICBT, which can inform further efforts to tailor ICBT for PSP (e.g., adapting course materials and examples to take into account these operational and occupational stressors).

Perceptions of client stories in internet-delivered cognitive behaviour therapy: A mixed-methods evaluation

“…By addressing clients' previous suggestion of increasing contextual dimensions in the stories (e.g., parenting, neurodiversity), the stories may also become more realistic to clients. Some clients noted room for improvement on formatting, which has been previously reported ( Beahm et al, 2022 ), although current desires for the stories to be more concise or fewer in number is a new finding that has not been reported in previous evaluations of the Wellbeing Course.…”

“…Potential improvements included adding more examples that would assist PSP with the application of material to their circumstances ( Beahm et al, 2021 ). In a follow-up study, over one-third of clients from the same program reported that stories were helpful, with a small number (about 10 %) reporting not liking or not resonating with the stories ( Beahm et al, 2022 ). Some felt that the readability of written stories could be improved with font and colour changes or paired with audio and video narrations.…”

Examining how organizational leaders perceive internet-delivered cognitive behavioural therapy for public safety personnel using the RE-AIM implementation framework

“…The current study results were also used to make iterative changes to PSPNET and supports the use of feedback from leaders as a method of improving ICBT. Previous PSPNET research has used data from clients to improve PSPNET courses but did not provide insights into outreach or promotion ( Beahm et al, 2022 ). Data from leaders in the current study provides complementary insights into facilitators, barriers, and improvements to outreach and promotion efforts.…”

Web-Based Mindfulness Meditation as an Adjunct to Internet-Delivered Cognitive Behavioral Therapy for Public Safety Personnel: Mixed Methods Feasibility Evaluation Study

“…In written feedback, PSP who participated in iCBT reported appreciating several aspects of iCBT, including the format and content, the accessibility of the course, the additional resources and examples, and the therapist guidance [ 12 ]. Nevertheless, some PSP also reported challenges with learning skills [ 13 ] and provided suggestions for improving iCBT, including adding more resources [ 12 ].…”