Gender Differences in Usage and Subjective Appreciation of an Online Cognitive Behavioral Therapy for Wildfire Evacuees: Descriptive Study.

BACKGROUND: Based on the most common psychological difficulties of the evacuees from the 2016 Fort McMurray wildfires in Alberta, Canada, a therapist-guided cognitive behavioral self-treatment was developed. This study aimed to explore how gender influences the usage and subjective appreciation of the RESILIENT online treatment. METHODS: Our study included 81 English-speaking evacuees with significant posttraumatic symptoms, or with some posttraumatic symptoms accompanied by at least mild depression symptoms or subclinical insomnia, and who logged into the platform at least once. Various usage and subjective appreciation variables were analyzed, including number of completed sessions, number of logins, number of words per session, perceived efforts, perception of usefulness and intention to continue using the different strategies. RESULTS: No difference was detected in most objective usage indicators. The number of words written in sessions 7 and 10 was significantly greater for women than for men. Regarding subjective appreciation, men had a greater perception of having put strong efforts in the cognitive restructuring strategy, while women reported in a greater proportion that they wanted to continue using physical exercise as a behavioral activation strategy. CONCLUSIONS: Our study offers a first look into how women and men use online treatments, and what their preferences are.

[Using Technology to Optimize the Training of Mental Health Providers in Evidence-Based Treatment: State of Knowledge]. / L'utilisation des technologies pour optimiser la formation des intervenants en santé mentale aux traitements fondés sur les données probantes : où en sommes-nous ?

Massive training of mental health providers is one of the proposed means of improving access to evidence-based treatment for a variety of common mental disorders. While communication and knowledge dissemination technologies (videoconferencing, web platforms) can help make training more accessible in time and space, their contribution to the development of skills among providers needs to be carefully evaluated. Objectives Establish how technologies are used to optimize the training of practitioners and what are the effects of online training on the acquisition of clinical knowledge and skills. Method A quick review of the literature was conducted. In order to be included, studies had to concern online training intended for providers in active clinical practice, deal with the treatment of a common mental disorder or addiction, and include an objective measure of clinical knowledge or skills. The studies were analyzed and compared in terms of learning methods and activities incorporating digital technologies. Results Twenty studies were identified. Passive learning methods, involving little or no interactivity, are predominant in asynchronous mode online training (AOT), while activities that allow a high level of interaction with the trainer, such as role-playing or supervision, are found in synchronous mode training. Knowledge acquisition: AOTs appear to be effective in improving the knowledge of the trainees for at least six months. Classroom training or the addition of supervision does not produce learning outcomes that are superior to the AOT. Skill acquisition: No conclusions can be drawn about the effects of online, asynchronous, synchronous or blended training, as the results are mixed or even contradictory. Conclusion Considering the low methodological quality of the studies analyzed, which limits the nature and scope of the conclusions of this review, the results of the studies suggest that AOTs that include basic interactive technologies, such as online quizzes, can be a simple and effective way to improve clinical knowledge of mental health practitioners.

[Usage Data of an Online Multidimensional Treatment to Promote Resilience After a Disaster]. / Données d'utilisation d'un autotraitement guidé en ligne pour promouvoir la résilience après une catastrophe naturelle.

Objectives Despite the existence of several online treatments for people with posttraumatic stress disorder (PTSD), few studies have examined usage data for such interventions. Given the potential of the online modality to alleviate barriers limiting access to psychological help, it is important to document users' interactions with these tools in relation to the improvement of targeted symptoms. The objective of this study is to document usage data of the online treatment platform RESILIENT by people evacuated from the Fort McMurray, Alberta (Canada) fires, and to examine their association with the effectiveness of treatment on symptoms of posttraumatic stress disorder (PTSD), insomnia and depression, and adherence to treatment, as measured by the number of modules accessed by participants. Methods Ninety-seven people evacuated from the Fort McMurray fires with symptoms of PTSD, insomnia and depression were included in this study. Participants were invited to use the RESILIENT platform, an online therapist-assisted self-help treatment program that targets PTSD symptoms, sleep and mood, and includes 12 modules offering evidence-based cognitive-behavioural therapy (CBT) strategies. Both objective (e.g., number of modules accessed) and subjective (e.g., level of effort invested) usage data were collected. Results In order to predict the reduction in PTSD, depression and insomnia symptoms, as well as the number of modules accessed by participants, sequential regression models were conducted, with statistical control for pretreatment symptoms, age and gender. The final models revealed that a reduction in PTSD, depression and insomnia symptoms was significantly predicted by the number of modules accessed (ß = -.41; -.53; -.49 respectively, all p <.001) as well as the mean self-reported level of effort at module 7 (midway) (ß = -.43; p <.001; ß = -.38; p = .005 and ß = -.36; p = .007 respectively). The number of modules accessed, on the other hand, was significantly predicted by the number of words in the 4th module (ß = .34; p <.001) and 7th module (ß = .44; p <.001) and the number of sleep diary entries (ß = .28; p <.001). Conclusion These results confirmed that increased interaction with the platform positively influences treatment effectiveness and that increased use at the beginning of treatment appears to be a good predictor of treatment completion. This study confirms the importance of sustaining participants' commitment to online treatment in order to optimize its effectiveness.

A Portrait of Mental Health Services Utilization and Perceived Barriers to Care in Men and Women Evacuated During the 2016 Fort McMurray Wildfires.

This study examines the influence of gender on mental health services utilization and on perceived barriers to treatment one year after the 2016 Fort McMurray wildfires. Data was collected through a phone survey from May to July 2017 (N = 1510). Participants were English-speaking evacuees aged 18 and older. Mental health services utilization and barriers to mental health care were assessed with the Perceived Need for Care questionnaire. Probable diagnoses of posttraumatic stress disorder, depression and insomnia were assessed with validated self-report questionnaires. Multiple logistic regressions confirmed that gender was a significant predictor of services utilization, after controlling for associated sociodemographic variables and presence of probable diagnoses. Women were respectively 1.50, 1.55 and 1.86 times more likely than men to receive information, medication and psychological help. Self-reliance was the most frequently reported reason for not receiving help, and motivational barriers, such as pessimism and stigma, were reported in a higher proportion than structural barriers, including nonresponse and finance. No significant gender differences were found in the types of perceived barriers to services. Among the Fort McMurray fire evacuees, mental health services utilization was similar to other studies on natural disaster victims, and higher in women than in men. Efforts to increase services utilization in natural disaster victims should focus on motivational barriers and offering treatments fostering people's autonomy, such as online treatments.