Parents of neurodiverse children are more likely to experience traumatic events related to the care of their child/children. This increases the probability to experience Posttraumatic Stress Injury (PTSI). However, interventions addressing PTSI symptoms in parents are rare. In this research project the study investigators will test the feasibility and efficacy of e-NET, a distance-delivered, exposure-based intervention for PTSI adapted to the needs of parents of neurodiverse children. E-NET is an adapted version of the Narrative Exposure Therapy (NET), an evidence-based intervention approach for individuals with PTSI who have experienced repeated or continuous trauma. The intervention will be conducted via videoconferencing with trained paraprofessionals. During the intervention a narrative of both positive and negative (traumatic) experiences in the parents' life will be created. The intervention contains approx. 12 one-on-one sessions with a trained paraprofessional via videoconferencing. The study design is a waitlist control group design. Approx. 20 participants will receive e-NET directly after the baseline survey and 20 participants will receive e-NET approx. 3 months after the baseline survey. To test the efficacy of the intervention, participants will fill out surveys about PTSI and other mental health symptoms before, directly after, and 2 and 6 months after the intervention. Adverse events and distress will be assessed in every session. As part of the baseline, participants will complete the survey "Surviving and Thriving in Parenting Neurodiverse Children" to determine their eligibility for the intervention. Main eligibility criterion is the presence of PTSI symptoms.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
66
One-on-one distance coached intervention; approx. 12 sessions at 60-90 minutes.
IWK Health Centre
Halifax, Nova Scotia, Canada
Change in PTSI symptoms
PTSD symptoms are measured with the PTSD Checklist - 5 (PCL-5). Respondents are asked to rate how bothered they have been by each of 20 items in the past month on a 5- point Likert scale ranging from 0-4. Items are summed to provide a total severity score. Higher scores indicate a worse outcome
Time frame: Baseline, Immediately Post- intervention, 2 months post-intervention, 6 months post-intervention
Change in Overall Health
General health will be measured with the questionnaire PROMIS Global Health Caregiver's general health
Time frame: Baseline, Wait-list Baseline; through study completion, an average of 12 weeks; Immediately Post-assessment; 2 month follow up; 6 month follow up
Change in Depression Symptoms
Depression symptoms will be measured with the Patient Health Questionnaire (PHQ-9)
Time frame: Baseline, Immediately Post-assessment, 2 month follow up, 6 month follow up
Change in overall functionality
Functionality will be measured with the Sheehan Disability Scale (SDS). SDS is measured on a 10-point scale (0-9). Higher score indicates a worse outcome.
Time frame: Baseline; Wait list Baseline, Immediately Post intervention; 2 month follow up; 6 month follow up
Posttraumatic Growth
Posttraumatic growth will be measures using the Posttraumatic Growth Inventory - Short Form (PTGI ). The PTGI is measured on a 6-point Likert scale (score 0-5). Higher score indicates a better outcome.
Time frame: Baeline; Wait list Baseline; Immediately Post intervention; 2 month follow up; 6 month follow up
Parent-child Relationship
The parent-child relationship will be measured with the Parent and Family Adjustment Scales (PAFAS). Items are rated from 0 to 3. Note that shaded items in the scoring key below must be reverse scored (i.e. 0=3, 1=2, 2=1, 3=0) before summing the Total Score. High scores indicate worse outcome.
Time frame: Baseline; Wait list Baseline; Immediately Post intervention; 2 month follow up; 6 month follow up
Satisfaction with Lifeline Tool
The satisfaction with Lifeline Tool (self-constructed) will be measured with a self-constructed 3-item usability questionnaire. It is scored on a five point scale. Items are rated from 0-4. Higher score indicates better outcome.
Time frame: During week 1 of intervention
Change in Anxiety Symptoms
Anxiety Symptoms are measured with the Generalized Anxiety Disorder (GAD-7). Items are scored on a four point scale, items are rated from 0-3. Higher score indicates better outcome.
Time frame: Baseline, Immediately Post-assessment, 2 month follow up, 6 month follow up
Change in Physical Health Symptoms
Physical Health symptoms will be assessed with the Patient Health Questionnaire Physical Symptoms (PHQ-15). Items are scored on a three point scale, items are rated from 0-2. Higher score indicates worse outcome.
Time frame: Baseline; throughout study completion, approximately 12 week; Immediately Post-assessment; 2 month follow up; 6 month follow up
Adverse Events
Adverse events will be assessed with a self-constructed questionnaire for adverse events, the course of symptoms during intervention and general distress.
Time frame: throughout study completion, approximately 12 weeks; immediately post intervention
Therapeutic Alliance
The interaction between coach and client will be assessed through the Therapeutic Alliance- Working Alliance Inventory - Short Form Revised (WAI-SR)
Time frame: Immediately post intervention
Participant Satisfaction
Client satisfaction will be assessed with the Client Satisfaction Questionnaire (CSQ-8) and some additional (self-constructed) qualitative questions. CAQ-8 Items are scored on a four point scale, items are rated from 0-3. Higher score indicates worse outcome.
Time frame: Immediately Post intervention
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