Overview
The study design is a two-arm randomized controlled pilot trial. The investigators will recruit Inuit in Montreal and randomly assign them to two treatment groups (n=20 each). The active psychotherapy group will receive a ten-week manualized virtual reality (VR) assisted cognitive-behavioral psychotherapy (VR-CBT) at the clinic and guided by a psychotherapist. The VR-CBT will aim at improving emotion regulation. The comparison group will use a VR self-management program, Calm Place, for guided relaxation during ten weeks at home. To evaluate outcome in both groups, the researchers will measure self-reports of emotion regulation, affect, distress and well-being, as well as a psychophysiological reactivity paradigm pre-post treatment.
Description
In this protocol, the investigators present a proof-of-concept trial that will evaluate an active psychotherapy and self-management, both targeting emotion regulation skills. The study design is a two-arm randomized controlled trial. The investigators will recruit Inuit and randomly assign them to two treatment groups (n=20 each). The active psychotherapy group will receive a ten-week manualized virtual reality (VR) assisted cognitive-behavioral psychotherapy (VR-CBT) at the clinic and guided by a psychotherapist. The VR-CBT will aim at improving emotion regulation, a set of skills or competence that is impacted by traumatic experiences and mediates the effect of trauma on psychiatric symptoms. The investigators conducted a cultural adaptation of the therapy for Inuit with a co-design grounded in qualitative participatory methods. The comparison group will use a VR self-management program, Calm Place, for guided relaxation during ten weeks at home. To evaluate outcome in both groups, the researchers will include a psychophysiological reactivity paradigm pre-post treatment and self-reports of emotion regulation, anxiety, mood, substance use, functionality and quality of life. The investigators expect to see preliminary evidence that our VR-CBT can be more successful than guided VR relaxation with Calm Place (self-management) decreasing difficulties in emotion regulation, psychiatry symptoms, increasing well-being, and normalizing responses to stressful stimuli (reactivity).
Eligibility
Inclusion Criteria:
- Self-identify as Inuk
- Live in Montreal
- be between 14 to 60 years of age
- be proficient in English or French
- No history of cardiac conditions
- No history of epilepsy
- Can provide an emergency contact
- Tolerance of VR headset
- Tolerance of sensors
- Has no current suicidal or homicidal risk
- No history of psychosis or schizophrenia
- Current stable mood
- Is generally mentally stable
- Score less than 8 on the Alcohol Use Disorders Identification Test C
- Score less than 3 on the Drug Abuse Screen Test (10 item version)
- Not have had any change in psychoactive medications during 4 weeks preceding screening and inclusion to the study
Exclusion Criteria:
- does not identify as Inuk
- youth below the age of 14 and adults above the age of 60.
- self-reported history of psychosis or schizophrenia
- current substance abuse, as measured by two screens (AUDIT-C, DAST-10)
- other mental or physical condition that might preclude them from the trial (i.e., pre-existing heart conditions, convulsions, acute mental health risk).