Accepted for/Published in: JMIR Formative Research
Date Submitted: Jul 18, 2024
Date Accepted: Sep 20, 2024
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Case Stories in Internet-Delivered Cognitive Behavioral Therapy for Public Safety Personnel: A Mixed-Methods Study
ABSTRACT
Background:
Internet-delivered cognitive behavioral therapy (ICBT) is an effective and convenient means of offering cognitive behavioral therapy among the general population. To help increase access to ICBT among Canadian public safety personnel (PSP)—a group that tends to experience elevated rates of mental health concerns and faces barriers to mental healthcare—a clinical research unit called PSPNET has tailored ICBT to PSP, primarily through offering case stories and PSP-specific examples. PSPNET’s first and most frequently used ICBT program, called the PSP Wellbeing Course, has been found to reduce symptoms of mental disorders (eg, anxiety, depression, posttraumatic stress) among PSP. Little research, however, has investigated clients’ perceptions of the case stories in this course.
Objective:
The current study was designed to expand literature on the use and evaluation of case stories in ICBT among PSP. Specifically, the current study investigated: (1) PSP’s perceptions of the case stories using the theoretical model provided by Shaffer and Zikmund-Fisher [21]; and (2) PSP feedback on the case stories in the PSP Wellbeing Course.
Methods:
The current study included 41 clients who completed the PSP Wellbeing Course. Of these clients, 27 completed a bespoke questionnaire called the Stories Questionnaire, 10 of whom also participated in a semi-structured interview.
Results:
Findings show that perceptions of the case stories in the PSP Wellbeing Course are largely positive and that the case stories were generally successful in achieving the five purposes of case stories (ie, informing, comforting, modeling, engaging, and persuading) proposed by Shaffer and Zikmund-Fisher [21]. Client feedback also identified three tangible areas for story improvement: characters, content, and delivery. Each area highlights the need for and potential benefits of story development. Not all PSP engaged with the case stories, though, so results must be interpreted with caution.
Conclusions:
Overall, the current study adds to the growing body of research supporting the use of case stories in internet-delivered interventions among PSP. Clinical Trial: Clinicaltrials.gov NCT04127032
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