Promoting mental health in high-risk occupations: A feasibility study to promote psychological capital in medical students and junior doctors.

This study will examine the feasibility of a workshop-delivered intervention to boost PsyCap and reduce poor mental health among University of Tasmania medical students and RHH junior medical officers. Using a randomised trial, we will compare the PsyCap workshop with an active control condition (psychoeducation only) and the PsyCap workshop plus a “booster session” and test the following hypotheses: Hypothesis 1: Intervention will increase PsyCap (resilience, optimism, self-efficacy, and hope) will reduce CF and psychological distress; and Hypothesis 2: Increased PsyCap (resilience, optimism, self-efficacy, and hope) will reduce CF and psychological distress. Hypothesis 3: The PsyCap + booster session group will maintain the positive effect of the intervention for longer. Participants from all three groups will be invited to attend group-based workshops (20-25 participants per group). The intervention will be implemented through a single one-off 3.5 hour facilitated group-based workshop. Online surveys will assess medical students and JMOs in all three groups at baseline, at intervention completion, and at 6-month follow up. Any improvement in ProQoL, depression, and anxiety as a result of increased PsyCap will be expected at 6- and 12-months (H2). All three groups (PsyCap, PsyCap+booster, and control) will also be assessed at 12-month follow-up to examine the maintenance of effects (H3). Psychological Capital Intervention (PCI) The PCI model aims to: (1) be brief (e.g. 3-4 hours); (2) enhance all four dimensions of PsyCap; and (3) enhance overall PsyCap through integration of the underlying principles and developmental aspects of each of the four individual PsyCap resource. The PCI involves a series of exercises individuals complete within a facilitated group-based workshop format (approx. 20-25 participants). The exercises develop each individual component of PsyCap (hope, efficacy, resilience and optimism), along with more integrative, reflective exercises which incorporate the development of the individual component training into an understanding and operationalization of overall PsyCap. For instance, individuals are asked to consider a personally meaningful work (or study) related goal. In identifying this goal, the individual is assisted by the facilitator to phrase the goal to enhance ‘agentic capacity’ and to ‘step’ goals into manageable units. The individual is then guided to generate several pathways that could enable them to achieve this goal. A critical element of the PCI delivery is facilitated small group discussions where individuals share their goals and pathways to generate additional pathways and model positive goal-setting behavior to the group. This group process enhances participants’ level of self-efficacy through the generation of additional pathways to achieve their stated goal/s; while also enhancing their positive expectations (optimism) to achieve it. The generation of multiple pathways for goal achievement also increases resilience by enabling participants to ‘bounce back’ by selecting an alternative pathway, if an original pathway is blocked or met with challenge. The final element of the PCI focuses on optimism development by increasing participants’ awareness of negative cognitions they may possess when faced with a challenge at work. This element is based upon cognitive-behavioral theory which posits people tend to make automatic, unfounded, negative cognitions when confronted with problems, which generates negative behaviors (e.g. “This is hopeless, I can’t possibly complete this assignment by the deadline. I give up!”). The PCI optimism development phase aims to counter negative cognitive distortions by encouraging participants to identify, challenge and replace them with more positively-oriented, realistic expectations (e.g. “This assignment is going to take a lot of work, but I have done similar assignments before and can do this one if I keep working”). Psychoeducation materials are provided to all three groups. PsyCap and PsyCap+booster groups will receive these at the workshop. The control group will be email electronic versions of these materials at their nominated email address. One of the groups that receive the PsyCap training workshop will also receive a 1.5-hour PsyCap booster session delivered 2 months following the initial workshop. This facilitated booster session will also be delivered in a group-based workshop format. The booster sessions are designed to provide an opportunity for participants to further develop the skills learned in the initial workshop and to tailor these skills to their own personal work/study-related goals and challenges. The PCI and booster sessions will be facilitated by trained educators/clinical psychologists who have extensive experience in workshop facilitation (Dr. Sarah Dawkins, Prof. Angela Martin) and will involve role-play, group discussion and exercises similar to the initial workshop.