Friday, Oct. 20
14:30 – 15:30 (N/A)
Meeting Room: Finback (3rd floor – B Tower)
Jitender Sareen*, MD

CanMEDS Roles:

1. Medical Expert
2. Leader
3. Professional

At the end of this session, participants will be able to: 1) Review the evidence for cognitive-behavioural therapy with mindfulness classes for depression and anxiety; 2) Review the high prevalence of mental health problems among public safety personnel; and 3) Present findings from a pilot randomized controlled trial.

Cognitive-behavioural therapy (CBT) has evidence in preventing depression among at-risk populations. Public safety personnel (PSP) have high rates of mental health problems and are exposed to high levels of stress and trauma. We conducted a randomized controlled trial to test the feasibility and acceptability of a five-class CBT with mindfulness classes (CBTm) intervention on variables contributing to workplace resilience among PSP.
Methods: We recruited 120 active duty police officers, firefighters, and paramedics into a parallel assignment randomized controlled trial. People were excluded if they had any of the following criteria: a) diagnosis of a mental health condition or suicidal ideation in the last six months, b) Patient Health Questionnaire-9 (PHQ-9) scores over 9, c) generalized anxiety disorder (GAD-7) score over 9, and d) post-traumatic stress disorder checklist-5 (PCL-5) score over 36.
Study arms: 1) five CBTm classes (1.5 hours each) delivered once weekly over five weeks; 2) waiting list for three months
Primary Outcomes: Changes in distress (PHQ-9, GAD-7, PCL-5) and Connor-Davidson Resilience Scale pre-, post- and three months after classes.
Results: Sixty participants were recruited between August 2019 and January 2021. The pilot randomized controlled trial (RCT) was successful in recruiting participants; however, COVID-19 pandemic restrictions impacted recruitment. CBTm classes were found to be acceptable to participants. Although not powered to detect differences, the intervention group differed significantly from the waiting list group on PCL-5 and PHQ-9 measures.
Conclusions: CBTm classes were acceptable to PSP as a prevention tool and showed promising results.

References:

1. Thakur VK, Wong JY, Randall JR, et al. An evaluation of large group cognitive behavior therapy with mindfulnes classes. BMC Psychiatry 2019;19(1):132.
2. Davidson D, Kinley J, Wong JY, et al. An evaluation of cognitive behavior therapy with mindfulness (CBTm) classes and telepsychology in rural settings. J Ration Emot Cogn Behav Ther 2022;40:369–387.