An Open Label Pilot Study of a Brief Psychosocial Intervention for Disaster and Trauma Survivors

Meaghan Louise O'Donnell; Winnie Lau; Julia Fredrickson; Kari Gibson; Richard Allan Bryant; Jonathan Bisson; Susie Burke; Walter Busuttil; Andrew Coghlan; Mark Creamer; Debbie Gray; Neil Greenberg; Brett McDermott; Alexander C McFarlane; Candice M Monson; Andrea Phelps; Josef I Ruzek; Paula P Schnurr; Janette Ugsang; Patricia Watson; Shona Whitton; Richard Williams; Sean Cowlishaw; David Forbes

doi:10.3389/fpsyt.2020.00483

An Open Label Pilot Study of a Brief Psychosocial Intervention for Disaster and Trauma Survivors

Front Psychiatry. 2020 Jun 26:11:483. doi: 10.3389/fpsyt.2020.00483. eCollection 2020.

Authors

Meaghan Louise O'Donnell^{1

2}, Winnie Lau^{1

2}, Julia Fredrickson^{1

2}, Kari Gibson^{1

2}, Richard Allan Bryant³, Jonathan Bisson⁴, Susie Burke⁵, Walter Busuttil⁶, Andrew Coghlan⁷, Mark Creamer², Debbie Gray⁸, Neil Greenberg⁹, Brett McDermott¹⁰, Alexander C McFarlane¹¹, Candice M Monson¹², Andrea Phelps^{1

2}, Josef I Ruzek^{13

14}, Paula P Schnurr^{15

16}, Janette Ugsang¹⁷, Patricia Watson¹³, Shona Whitton⁷, Richard Williams¹⁸, Sean Cowlishaw^{1

2

19}, David Forbes^{1

2}

Affiliations

¹ Phoenix Australia Centre for Posttraumatic Mental Health, The University of Melbourne, Carlton, VIC, Australia.
² Department of Psychiatry, University of Melbourne, Carlton, VIC, Australia.
³ School of Psychology, University of New South Wales, UNSW Sydney, Kensington, NSW, Australia.
⁴ Division of Psychological Medicine and Clinical Neuroscience, Cardiff University, Cardiff, United Kingdom.
⁵ Australian Psychological Society, Melbourne, VIC, Australia.
⁶ Department of Psychiatry, Combat Stress, UK, Leatherhead, United Kingdom.
⁷ Australian Red Cross, North Melbourne, VIC, Australia.
⁸ Mental Health Promotion and Illness Prevention, Addiction Mental Health - Alberta Health Services, Calgary, AB, Canada.
⁹ Academic Department of Military Mental Health, King's College London, London, United Kingdom.
¹⁰ College of Medicine and Dentistry, James Cook University, Douglas, QLD, Australia.
¹¹ Centre for Traumatic Stress Studies, The University of Adelaide, Adelaide, SA, Australia.
¹² Department of Psychology, Ryerson University, Toronto, ON, Canada.
¹³ National Center for PTSD, Dissemination and Training Division, US Department of Veterans Affairs, Palto Alto, CA, United States.
¹⁴ Department of Psychiatry and Behavioral Sciences, Stanford University, CA, United States.
¹⁵ National Center for PTSD, Executive Division, US Department of Veterans Affairs, White River Junction, VT, United States.
¹⁶ Department of Psychiatry, Geisel School of Medicine, Dartmouth, Hanover, NH, United States.
¹⁷ Asian Disaster Preparedness Center, Bangkok, Thailand.
¹⁸ Welsh Institute for Health and Social Care, University of South Wales, Wales, United Kingdom.
¹⁹ Bristol Medical School, University of Bristol, Bristol, United Kingdom.

Abstract

Background: In the aftermath of disaster, a large proportion of people will develop psychosocial difficulties that impair recovery, but for which presentations do not meet threshold criteria for disorder. Although these adjustment problems can cause high distress and impairment, and often have a trajectory towards mental health disorder, few evidence-based interventions are available to facilitate recovery.

Objective: This paper describes the development and pilot testing of an internationally developed, brief, and scalable psychosocial intervention that targets distress and poor adjustment following disaster and trauma.

Method: The Skills fOr Life Adjustment and Resilience (SOLAR) program was developed by an international collaboration of trauma and disaster mental health experts through an iterative expert consensus process. The resulting five session, skills-based intervention, deliverable by community-based or frontline health or disaster workers with little or no formal mental health training (known as coaches), was piloted with 15 Australian bushfire survivors using a pre-post with follow up, mixed-methods design study.

Results: Findings from this pilot demonstrated that the SOLAR program was safe and feasible for non-mental health frontline workers (coaches) to deliver locally after two days of training. Participants' attendance rates and feedback about the program indicated that the program was acceptable. Pre-post quantitative analysis demonstrated reductions in psychological distress, posttraumatic stress symptoms, and impairment.

Conclusions: This study provides preliminary evidence that the delivery of the SOLAR program after disaster by trained, frontline workers with little or no mental health experience is feasible, acceptable, safe, and beneficial in reducing psychological symptoms and impairment among disaster survivors. Randomized controlled trials of the SOLAR program are required to advance evidence of its efficacy.

Keywords: adjustment disorder; brief intervention; disaster; posttraumatic stress; psychosocial intervention; sub-clinical; sub-syndromal; trauma.

Copyright © 2020 O'Donnell, Lau, Fredrickson, Gibson, Bryant, Bisson, Burke, Busuttil, Coghlan, Creamer, Gray, Greenberg, McDermott, McFarlane, Monson, Phelps, Ruzek, Schnurr, Ugsang, Watson, Whitton, Williams, Cowlishaw and Forbes.