A Scoping Review of the Role and Training of Para-professionals Delivering Psychological Interventions for Adults with Post-traumatic Stress Disorder
2019
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.
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