Evaluation of SHAPE cognitive therapy coaching for PTSD and depression symptoms in healthcare workers repeatedly exposed to trauma

Abstract

Healthcare workers are at increased risk of posttraumatic stress disorder (PTSD), depression and generalised anxiety disorder. Evidence-based interventions tailored to this workforce are limited. We developed and evaluated a telephone-based cognitive therapy coaching intervention targeting PTSD and depression. One hundred three healthcare workers seeking support during the COVID-19 pandemic completed measures at baseline, after three-week symptom monitoring, following six-week coaching, and at three-month follow-up. Sixty-five participants met criteria for probable PTSD (PCL-5 ≥ 32) or probable depression (PHQ-9 ≥ 10), and 38 experienced subthreshold symptoms. For PTSD (PCL-5) and depression (PHQ-9), reliable recovery rates increased substantially from symptom monitoring (PTSD: 14.6%; depression: 15.8%) to intervention (PTSD: 77.1%; depression: 64.3%), with sustained recovery at three months (68.8% and 52.6%, respectively). Overall, rates of reliable improvement increased from 41.1% to 65.8% for PTSD and from 20.0% to 63.1% for depression during intervention, with gains maintained at follow-up (72.2% and 56.0%, respectively). Mean PTSD, depression and anxiety (GAD-7) scores fell below clinical thresholds post-intervention and remained below at follow-up. Intervention-specific effects were observed for sleep, resilience, and wellbeing, with sustained improvements at follow-up. Cognitive therapy coaching is a promising intervention for healthcare workers with PTSD and depression symptoms. A randomised controlled trial is warranted.