A summary review of the development of using a brief imagery-competing task intervention (ICTI) for reducing intrusive memories of psychological trauma: applications in healthcare settings for both staff and patients.

Abstract

Psychological trauma for those utilising and delivering healthcare is common, and in particular the experience of repeated and unwanted intrusive memories (IM) of the trauma can occur. There are several psychological interventions that have been shown to be effective with the full syndrome of Post Traumatic Stress Disorder (PTSD), but researchers have only recently explored targeted interventions for IMs. This review provides a summary of a body of work on a behavioural technique called "Imagery Competing Task Intervention" (ICTI) for intrusive memories after trauma by Holmes and colleagues. The papers presented outline the underlying cognitive science, the historical development of the intervention, and its application to various different populations in healthcare settings including clinical tests of efficacy. Settings and populations include traumatic events experienced by emergency department patients and emergency caesarean section patients, as well as after work-related trauma experienced by intensive care staff and wider healthcare staff. Timing of ICTI intervention delivery has included the same day of trauma, within 72 h and for older memories weeks, months (or years) post-trauma. The intervention has been delivered with a guided session, which in some studies is in person and some remotely via digital health application. There is a brief overview of other related interventions. The ICTI approach shows potential scalability in trauma laden environments such as healthcare, where exposure is unlikely to be limited or managed and symptoms such as subclinical IMs are common. As such the intervention could be used in a preventing-and-treating approach and in subclinical-to-clinical samples who have IMs after exposure to psychological trauma. Future research would be needed to test ICTI as an intervention for the full syndrome of PTSD.