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Symposia

Sleep / Wake Disorders

Community-academic partnerships to increase access to CBT treatments that improve sleep and circadian functioning

3 - (SYM 123) An Efficient Treatment for Posttraumatic Stress Injury for Firefighters

Sunday, November 17, 2024
8:30 AM – 10:00 AM EST
Location: Liberty A, Level 3, Downtown Marriott
Abstract Body

Firefighters experience elevated rates of posttraumatic stress disorder, or “posttraumatic stress injury (PTSI)”, that can significantly impair occupational functioning. However, firefighters have limited access to evidence-based treatment that fits within their work and training schedules. In addition, treating comorbid insomnia and nightmares is critical to improving outcomes for the treatment of PTSI, but integrated treatments are unavailable. Brief, culturally adapted evidence-based treatment is needed to help firefighters with PTSI benefit from effective care. We are conducting a two-phase study that began with interviewing a total of 45 stakeholders, including 14 fire service leaders, 14 providers, and 17 firefighters to develop and test an accelerated, integrated treatment for PTSI, insomnia, and nightmares tailored to the unique strengths and mental health needs of firefighters. Qualitative data revealed three primary challenges to implementing the treatment: stigma, spreading awareness, and scheduling. Identified solutions included emphasizing confidentiality and providing treatment at a private location, using testimonials and culturally competent providers, and providing accommodation and meals and letters to supervisors as needed. We are now conducting a pilot clinical trial to examine the acceptability, feasibility, and effectiveness of the program. Treatment integrates written exposure therapy with CBT for insomnia and nightmares and involves four consecutive half days of group therapy delivered in a retreat format in the community with individual sessions on either side. Fifty participants will be randomized to either immediate or delayed treatment groups that are scheduled through July 2024. Data collected to date from five participants (N=5) indicate positive trends: from baseline to the 1-month post-treatment, beta group participants showed reductions on the PTSD Checklist for DSM-5 from M = 45.6 (8.99) to 21.75 (8.66) and on the Insomnia Severity Index from 18.2 (6.06) to 8.75 (5.19) and a reduction in the number of nightmares in the past month from 7.4 (5.55) to 0.5 (1.0). Interview and survey data collection for the pilot trial will be complete by November 2024. An efficient group workshop-format treatment provided in the community could increase accessibility, minimize the stigma of seeking mental health care, and hasten recovery from three commonly comorbid and interrelated disorders.