RESILIENT – a platform to improve resilience
Constance Boulé
Master’s student in psychoeducation, University of Montreal, Canada | October 2023
Rachel Primiani
Psychoeducator and doctoral student in psychoeducation, University of Montreal, Canada | October 2023
This article first appeared in Traumag (Fall 2023), a magazine published by the Trauma Studies Center affiliated with the University of Montreal. Permission for republication was obtained from the magazine’s editors and from the author. The article was originally published in French and translated by Alexandre Lemyre, Ph.D.
In October 2023, the RESILIENT platform is not available to the public, and it has not been translated in English.
In 2016, a forest fire ravaged the municipality of Fort McMurray in Alberta, requiring the evacuation of around 100,000 residents. The research team led by Geneviève Belleville, a professor at Laval University, was called in to provide psychological assistance to the population. The research team deployed its resources to assess the needs of fire survivors and created a tool to promote resilience: the RESILIENT platform (Lebel et al., 2021). A hundred Fort McMurray residents volunteered to test the tool. Here is a brief presentation of the platform and some indicators of its effectiveness.
RESILIENT: What is it?
This online self-help treatment targets symptoms of post-traumatic stress disorder, the promotion of healthy sleep habits, and mood changes. It comprises 12 intervention modules to be completed online, through which six interactive tools are introduced (the tools are available at all times). In the various modules, users are introduced to evidence-based cognitive-behavioral therapy (CBT) strategies.
Modules and tools on the RESILIENT platform
1. Normal reactions to abnormal events
STRATEGIES COVERED:
Psychological education on post-traumatic stress disorder
Daily self-observation
Behavioral activation
Sleep hygiene
TOOL INTRODUCED:
Sleep diary
2. Catching my breath
STRATEGIES COVERED:
Psychological education (reactions to a traumatic event)
Diaphragmatic breathing
Sleep restriction (CBT for insomnia)
TOOLS INTRODUCED:
Diaphragmatic breathing and behavioral activation
3. Facing my fears
STRATEGIES COVERED:
Gradual and prolonged exposure
Behavioral activation (physical exercise)
Stimulus control (CBT for insomnia)
TOOL INTRODUCED:
Gradual and prolonged exposure
4. Thinking out loud
STRATEGIES COVERED:
ABC model of cognitive therapy
Cognitive restructuring (changing the interpretation of events)
TOOL INTRODUCED:
Cognitive restructuring
5. Paying attention to how I talk to myself
STRATEGIES COVERED:
Cognitive restructuring (changing the negative internal monologue)
6. Reconnect with myself and others
STRATEGIES COVERED:
Optimizing social support
Mindfulness meditation
7. My progress so far
STRATEGIES COVERED:
Self-compassion
8. Revisiting difficult memories
STRATEGIES COVERED:
Imaginal exposure (recounting the traumatic event)
TOOL INTRODUCED:
Problem-solving
9. Keep moving forward
STRATEGIES COVERED:
Imaginal exposure (detailed traumatic memories)
Radical acceptance
10. Taking control
STRATEGIES COVERED:
Revision and repetition using mental imagery (nightmare control)
11. Looking to the future
STRATEGIES COVERED:
Reflecting on one’s own values, setting goals and taking action
12. Preparing my toolbox for life
STRATEGIES COVERED:
Relapse prevention
Toolbox
How does it work?
• Once a module had been completed, users had to wait a week to access the next one.
• Users had 6 months to complete the 12 modules of the RESILIENT platform.
• Each module contains different exercises. Users were free to complete only those exercises they felt were relevant to their specific situation.
• Weekly contacts by telephone or videoconference were also made by supervised doctoral students in clinical psychology. These contacts were made over a 12-week period, and helped to answer questions, ensure proper use of the platform, and support users as needed
What about the application’s effectiveness?
In 2023, Professor Belleville’s team published data on the impact of the self-help platform on symptoms of post-traumatic stress, depression, anxiety, and insomnia. These symptoms were present in more than a third of Fort McMurray evacuees one year after the disaster (Belleville et al., 2021), and the RESILIENT platform was introduced sixteen months after the disaster. After six months of use, the team observed a marked reduction in self-reported symptoms of post-traumatic stress, depression, insomnia, and anxiety. A significant increase in functioning was also observed, indicating recovery (Belleville, 2023). Among respondents, twenty-five percent of users completed at least half of the modules and showed more improvements (Belleville et al., 2023).
Such a low participation rate is frequently observed in studies of self-help treatment via mobile applications (Linardon et al., 2020). This point raises the importance of developing digital tools designed to keep users engaged, since it has been shown that adherence to self-help treatments could be correlated with their effectiveness (Furh et al., 2018). So the question is: how do we build a platform that will generate interest and engagement among users, and offer a variety of tools in order to be tailored to their needs? One possible solution could be the addition of a social and interactive component with other users, such as a support group (Monney et al., 2015).
References
Belleville, G., Ouellet, M. C., Békés, V., Lebel, J., Morin, C. M., Bouchard, S., Guay, S., Bergeron, N., Ghosh, S., Campbell T., & Macmaster, F. P. (2023). Efficacy of a therapist-assisted self-help internet-based intervention targeting PTSD, depression, and insomnia symptoms after a disaster: A randomized controlled trial. Behavior Therapy, 54(2), 230-246.
Belleville, G., Ouellet, M. C., Lebel, J., Ghosh, S., Morin, C. M., Bouchard, S., Guay, S., Bergeron, N., Campbell, T., & MacMaster, F. P. (2021). Psychological symptoms among evacuees from the 2016 Fort McMurray wildfires: A population-based survey one year later. Frontiers in Public Health, 9, Article 655357.
Fuhr, K., Schröder, J., Berger, T., Moritz, S., Meyer, B., Lutz, W., Hohagen, F., Hautzinger, M., & Klein, J. P. (2018). The association between adherence and outcome in an Internet intervention for depression. Journal of Affective Disorders, 229, 443-449.
Lebel, J., Flores-Tremblay, T., Binet, É., Ouellet, M. C., & Belleville, G. (2021). Données d’utilisation d’un autotraitement guidé en ligne pour promouvoir la résilience après une catastrophe naturelle [Usage data of an online multidimensional treatment to promote resilience after a disaster]. Santé mentale au Québec, 46(1), 203- 227.
Linardon, J., & Fuller-Tyszkiewicz, M. (2020). Attrition and adherence in smartphone-delivered interventions for mental health problems: A systematic and meta-analytic review. Journal of Consulting and Clinical Psychology, 88(1), 1-13.
Monney, G., Penzenstadler, L., Dupraz, O., Etter, J. F., & Khazaal, Y. (2015). mHealth app for cannabis users: Satisfaction and perceived usefulness. Frontiers in Psychiatry, 6, Article 120.
The content of this article was last updated on October 25, 2023
