The Efficacy of Brief Psychological Interventions for the Management of Psychological Distress in People Physically Injured in a Motor Vehicle Crash and Engaged in Compensation

Abstract

Psychological distress following a motor vehicle crash (MVC) is prevalent, especially when the person sustains a physical injury, and this distress is exacerbated when the person is engaged in compensation. If unmanaged, psychological distress can lead to negative psychosocial sequelae such as social disengagement, relationship stress, loss of employment, and poor quality of life. The first aim of this doctoral study involved a meta-analysis investigating psychological impacts of injuries sustained in a MVC. A second aim involved designing and implementing a randomized controlled trial (RCT), which included people injured in MVCs, and involved in compensation with one of three Australian insurance companies. The intervention provided brief email-delivered Cognitive Behaviour Therapy (CBT) or healthy lifestyle (HL) programs with fortnightly clinically-focussed telephone contact across ten weeks. An active wait-list Control group received claim-related information and telephone contact to ensure they had received this information. The meta-analysis results showed psychological distress was highly prevalent following a MVC. Preliminary results of the RCT showed a reduction in psychological distress for those with major depressive disorder (MDD) in the CBT group, while some improvement also occurred for those in the Control group. Those in the HL experienced increased distress. The provision of brief CBT sessions early after a MVC may provide protection against chronic psychological disorder for those with existing (MDD). For those without MDD, significant reductions in distress occurred regardless of group suggesting a beneficial long-term outcome may only require the provision of relevant claim-related material and a fortnightly telephone call, 3-6 months after entering compensation. Feasibility results suggest the interventions were acceptable by the majority of participants. This doctoral study extends current knowledge in rehabilitation medicine and psychology, as well as health and compensation fields, offering a rationale for modifications to existing policy and practice for insurance companies and health care organisations.