ICU Doulas Providing Psychological Support

Many patients who survive critical illness suffer from symptoms of anxiety, depression, or
post-traumatic stress disorder (PTSD) after leaving the intensive care unit (ICU). Memories
of frightening and delusional experiences in the ICU appear to be the strongest potentially
modifiable risk factor. Research on the formation of fear and associated memories shows that
if mitigating information about a traumatic event is introduced during the time between
memory formation and its recall, the emotional experience of the memory can be modified in a
positive manner. This means that in order to prevent mental health problems in critical
illness survivors, psychological support needs to take place in parallel with medical
treatment in the ICU. The Researchers hypothesize that early psychological support for the
critically ill can decrease mental health morbidity in critical illness survivors. However,
providing consistent psychological support intervention is a challenge for busy ICU
clinicians. It is not feasible to hire behavioral medicine trained psychologists to become
permanent ICU staff nationwide. Doulas, trained lay health care providers who provide
emotional support to women in labor, have been identified as reliable yet affordable
alternative. Given common elements of their services and our intervention, doulas are in an
ideal position to administer early psychological support. The objective of this project is to
refine and test a behavioral intervention to be administered in parallel with medical
treatment in the ICU. This will be accomplished by training doulas in providing standardized
psychological support intervention and refining the intervention based on stakeholder
feedback