The ethical imperative of trauma-sensitive care for electroconvulsive therapy (ECT)

Abstract

Background The empirical literature on the lived experience of electroconvulsive therapy (ECT) is limited, divergent, and largely focused on the experiences of procedures, (adverse) effects, information provision, or decision-making. Aims This study aimed to investigate aspects related to the lived experience and meaning-making of people who have had ECT. Method In-depth interviews with 21 women (21–65 years old) were analyzed using interpretative phenomenological analysis (IPA). Findings A subgroup of nine participants described more negative experiences with ECT. A common factor for these participants was the experience of trauma that remained under-treated. The superordinate themes identified were a lack of trauma-based and recovery-oriented treatment. The rest of the sample (12) expressed more positive experiences with ECT. Conclusions This study suggests that exploring more broadly the impacts of ECT at the long term offers insights that can help design more person-centered services aligned to the needs of the treatment recipients. Educational modules for mental health care staff should include, besides knowledge on the methods’ effectiveness, additional evidence about treatment recipients’ subjective concerns and the relevance of trauma and recovery-oriented care models.