None listed
Conditions
Brief summary
Rural Australians face significantly higher risk of suicide and trauma exposure compared to the general population (Kennedy et al., 2014; Miller & Burns, 2008; Milner et al., 2017), yet have limited access to mental health support. The MemFlex program offers a potential solution to challenges of accessibility and engagement in mental health care within rural Australia. MemFlex is a web-based, primarily self-directed treatment program that refocuses individuals towards positive memories from their past. Previous research has demonstrated the efficacy of the MemFlex in reducing symptoms of depressive and post-traumatic stress disorders (Hitchcock et al., 2021; Moradi et al., 2021). Here, we evaluate the acceptability and feasibility of offering a peer-led version of MemFlex to rural Australians experiencing psychological distress.
Interventions
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 low mood. 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 built upon via ten online self-guided sessions. A 45-60 minute orientation Zoom call with a facilitator 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 given access to 10 online, self-guided sessions and encouraged to complete 2-3 sessions (~15 mins) per week for 4-5 weeks, and can contact their facilitator with any questions. Number and frequency of session completion is monitored by the facilitator through website analytics. The facilitator will check in with participants after 2 weeks, then after 4 weeks following orientation. 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 care as usual design will be used. As the intervention is entirely online, including contact with the facilitator, participants can access the program when and where they feel comfortable to do so. One week after finishing the post-intervention assessment, participants allocate dot MemFlex will be given Managing Stress on the Farm.
Sponsors
University of Melbourne
Study design
Allocation
Randomised controlled trial
Intervention model
Crossover
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Participants (N = 40) will be adults (aged 18 years and above) experiencing psychological distress, recruited from rural areas in Australia, indexed as Modified Monash Model classification of MM2-MM7 (Australian Government Department of Health, 2023). To be included in the trial, participants will score above 24 on the K-10 indicating a moderate level of symptoms (Kessler et al., 2002), be proficient in reading and writing English, and have access to a computer or tablet.
Exclusion criteria
Medically confirmed diagnosis of cognitive impairment; or high levels of suicidality or have attempted suicide in the previous two months, as informed by the Suicidal Ideation Attributes Scale (Van Spijker et al., 2014). Individuals experiencing high levels of suicidality will be referred for more intensive, clinician-delivered support.
Outcome results
None listed