A randomised control trial of digital memory flexibility training (MemFlex) as an adjunct intervention for individuals with post-traumatic stress disorder (PTSD)

MemFlex: The MemFlex intervention aims to improve the ability to retrieve any autobiographical memory type on demand, using cued recall exercises. Participants are never asked to retrieve negative memories or trauma memories. In particular, the intervention trains three core skills: balancing, elaboration, and flexibility. Balancing aims to improve access to personally relevant memories that are emotionally positive. Improving ease of access to positive autobiographical information aims to balance against the negative self-appraisals that drive PTSD. Elaboration aims to increase the detail and vividness of these positive memories. Flexibility explicitly trains the ability to move between specific and general levels of memory representation. These skills are gradually introduced and build upon via eight online self-guided sessions. A 45 minute Zoom call with a support worker introduces the intervention. Participants are emailed a link to access the online sessions, which involve an initial psychoeducation component, and memory recall exercises using memory cues. In the sessions, participants are trained to recall event memories and general memories, to elaborate memories with contextual, emotional and somatic details, and to flexibly move between memory types. Participants are encouraged to complete two online, self-guided sessions (~20 mins) per week for 4 weeks, and can contact the worker with any questions. Treatment adherence is monitored by the support worker through website analytics. The worker will check in with participants each week of the trial. MemFlex participants will be able to continue any other offered activities (e.g., medication, psychological therapy). We will record access to services for each participant. That is, a MemFlex plus treatment as usual design will be used. As the intervention is entirely online, including contact with the support worker, participants can access the program when and where they feel comfortable to do so. At the end of the MemFlex intervention, participants will crossover into treatment as usual for a 4 week period.