Symposia
Disaster Mental Health
David J. Disabato, Ph.D.
Kent State University
Kent, Ohio
Karin Coifman, PhD
Professor
Kent State University
Kent, Ohio
Poor mental health in frontline workers is associated with clinical practice failures, adversely affecting patient health (Panagioti et al., 2017). During the COVID-19 pandemic, frontline workers have been particularly impacted while also being called upon to treat and save patients. Some prior evidence suggests that traditional psychotherapy approaches are limited in their efficacy during this time (Chen et al., 2020). To support mental health in frontline workers during COVID-19, we developed a novel, brief (3-6 minutes) intervention that could be administered to frontline workers on a daily basis: the Daily Coping Toolkit© (DCT). The DCT included three components based on prior research and completed via a smartphone app: 1) expressive writing about daily hassles, 2) self-distancing from distress, and 3) writing prompts to generate positive emotions. During May/June of 2020, we randomized 28 frontline workers in the Midwestern USA (75% female; M-age = 45.3, SD = 9.6) to receive one of two doses of the DCT (https://clinicaltrials.gov/ct2/show/NCT04398277). In the high dose, the DCT included two writing prompts to generate positive emotions (n = 13) versus one prompt in the low dose (n = 15). Forty-six percent of participants were medical personnel, 29% were support staff, and 21% were emergency responders. Participants reported momentary positive and negative emotions before and after completing the DCT once daily for 7 consecutive days. Averaged across doses, participants, and days, positive emotions increased by 13% (ΔM = +0.27, 95% CI [+.00, +.35]) and negative emotions decreased by 44% (ΔM = -0.28, 95% CI [-.43, -.14]) during the 3-6 minutes of the DCT. Linear mixed effects models testing the effect of dose found that participants received an additional 9.4% boost in positive emotions (B = .47, p = .018) and 7.8% drop in negative emotions (B = -.39, SE = .19, p = .058) when they received the higher dose. Seventy percent of participants rated the intervention as moderate to highly effective with negative side effects unlikely. In sum, one week of the DCT a day significantly improved mood for frontline workers during the first peak of COVID-19. Our findings are especially promising given 80% of the full sample reported a history of a psychiatric disorder or treatment. They suggest this novel, brief smartphone intervention can improve emotional well-being in frontline workers who are at elevated risk for poor mental health given their psychiatric histories (Richards, 2011). Our research team is currently replicating this RCT in other at-risk samples.