Efficacy of brief psychological interventions delivered early after the injury

It is estimated that up to 50% of motor vehicle crash (MVC) survivors will develop
significant psychological distress such as depressive mood and elevated anxiety within 6 months after the crash. Associated impacts include loss of employment, delayed return to work, financial and familial stress, and increased medical, legal and compensation costs. Investigations into interventions aimed at preventing psychological distress are limited. A research project was designed to examine whether brief email-delivered interventions distributed soon after someone has sustained a MVC-related injury and has entered into a compensation claims process, can be effective for preventing the development of psychological distress into more severe clinical levels of psychopathology such as major
depressive disorder (MDD) and post-traumatic stress disorder (PTSD). This chapter reports on a randomised, controlled multi-site study that investigated the outcomes of consenting adults randomly assigned to 1 of 3 groups: 1) a group who received a brief email-delivered CBT program involving 1 session every 2 weeks for 10 weeks with clinically focussed telephone contact every 2 weeks; 2) a group who received a brief email-delivered lifestyle intervention involving 1 session every 2 weeks for 10 weeks with clinically focussed telephone contact, and 3) an active waitlist control group who were provided with claims processing-related reading material along with non-clinically
focussed telephone contact every 2 weeks for 10 weeks. Participants were recruited within 12 weeks of the MVC, and were comprehensively assessed for sociodemographic, physical, psychosocial and mental health characteristics across 4 time points; pre-treatment, post-treatment, 6-months and 12 months post-injury. As part of this research project, two preliminary analyses were conducted midway through the trial. The aims of the first preliminary analysis were: 1) to determine rates of MDD and PTSD in adults with MVC-related injury who were engaged in compensation, and 2) determine the capacity (i. e. sensitivity and specificity) of two psychometric scales for estimating the presence of MDD and PTSD. The aims of the second preliminary analysis were to determine: 1) preliminary efficacy results of the two brief psychological interventions using pre- and post-treatment assessments, 2) determine whether either of the interventions were causing harm and stop the trial if necessary, and 3) analyse the feasibility, acceptability and generalisability of the brief interventions to inform future researchers in the field.