A Scoping Review of the Role and Training of Para-professionals Delivering Psychological Interventions for Adults with Post-traumatic Stress Disorder

Abstract

Background: The delivery of interventions for traumatic stress disorders by paraprofessionals is of interest across mental health systems as decision-makers work to meet growing need for services and demand for evidence-based care. Given the need for any system change to reflect scientific evidence, our scoping review aimed to identify and summarize the research on paraprofessional-delivered trauma-focused psychological interventions for adults, with a particular focus on the role and training of paraprofessionals. Method: We searched seven databases for peerreviewed published studies that employed controlled trial designs to evaluate paraprofessional-led interventions for traumatic stress. Using Covidence software, we completed iterative eligibility screening and extracted study data. Descriptive statistics were used to identify trends and gaps in the literature and inform synthesis of findings. Results: Fourteen studies met inclusion criteria. The majority of studies (71%; 10/14) evaluated interventions that were delivered face-to-face across a diverse patient populations and clinical contexts. Training of paraprofessionals ranged in length from two training sessions (approx. 16 hours) to a 6-week full day, in-person course. Ongoing supervision of paraprofessionals during the intervention was reported in 64% (9/14) of the studies, but few details of supervision processes were reported. Conclusion: Paraprofessionals are taking on therapeutic roles in the delivery of trauma-focused psychological interventions but there are significant knowledge gaps around training and supervision they require. Lack of consensus on the defining characteristics of a “paraprofessional” makes synthesizing this literature particularly challenging.