Promoting Improved Functioning Among People Experiencing Stressful Situations

Description

The iCOVER intervention was developed to rapidly restore functioning in individuals experiencing an Acute Stress Reaction (ASR). iCOVER is undergoing widespread adoption but has not been tested for efficacy. iCOVER was designed to be administered by peers, paraprofessionals, or medical personnel in 60-120 seconds, including in military operational environments. The term iCOVER is an acronym that summarizes the six specific steps of the intervention: (1) identify that an individual is experiencing an ASR; (2) Connect with the individual through word, eye contact, and physical touch to draw them back to the present moment; (3) Offer commitment so that the individual feels less psychologically isolated and withdrawn (e.g., "I'm right here with you"); (4) Verify facts - ask simple fact-based questions to engage the individual in deliberate cognitive activity; (5) Establish order of events - briefly review what has happened, what is happening, and what will happen to orient the individual; and (6) Request action to re-engage the individual in purposeful behavior. Participants will be randomly assigned to one of three groups: iCOVER, usual care, or physical presence with reassurance. Investigators have elected to use two different control conditions, in order to examine the reliability of the iCOVER intervention in comparison with two typical responses to individuals experiencing an ASR (i.e., physical presence with reassurance, no specific treatment).

Conditions

Acute Stress Reaction

Study Overview

Study Details

Study overview

The iCOVER intervention was developed to rapidly restore functioning in individuals experiencing an Acute Stress Reaction (ASR). iCOVER is undergoing widespread adoption but has not been tested for efficacy. iCOVER was designed to be administered by peers, paraprofessionals, or medical personnel in 60-120 seconds, including in military operational environments. The term iCOVER is an acronym that summarizes the six specific steps of the intervention: (1) identify that an individual is experiencing an ASR; (2) Connect with the individual through word, eye contact, and physical touch to draw them back to the present moment; (3) Offer commitment so that the individual feels less psychologically isolated and withdrawn (e.g., "I'm right here with you"); (4) Verify facts - ask simple fact-based questions to engage the individual in deliberate cognitive activity; (5) Establish order of events - briefly review what has happened, what is happening, and what will happen to orient the individual; and (6) Request action to re-engage the individual in purposeful behavior. Participants will be randomly assigned to one of three groups: iCOVER, usual care, or physical presence with reassurance. Investigators have elected to use two different control conditions, in order to examine the reliability of the iCOVER intervention in comparison with two typical responses to individuals experiencing an ASR (i.e., physical presence with reassurance, no specific treatment).

Promoting Improved Functioning Among People Experiencing Stressful Situations

Promoting Improved Functioning Among People Experiencing Stressful Situations

Condition
Acute Stress Reaction
Intervention / Treatment

-

Contacts and Locations

Belmont

McLean Hospital, Harvard Medical School, Belmont, Massachusetts, United States, 02478

Worcester

University of Massachusetts Chan Medical School, Worcester, Massachusetts, United States, 01655

Detroit

Henry Ford Health System, Detroit, Michigan, United States, 48202

Saint Louis

Washington University, St. Louis, Saint Louis, Missouri, United States, 63110

Camden

Cooper University Health Care, Camden, New Jersey, United States, 08103

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • * ≥ 18 years and ≤ 50 years of age (if age not known, appears to be)
  • * In the emergency department as a patient or loved one of a patient
  • * If a patient, anticipated to be discharged to home from the emergency department after evaluation
  • * Exhibiting visible signs of distress Richmond Agitation and Sedation Scale ((RASS) (+1 to +3)) or dissociation (awake and alert but reduced responsiveness)
  • * Likely able to speak English
  • * Known pregnancy
  • * Prisoner or in custody
  • * Known history of psychosis or bipolar disorder
  • * Known or suspected drug intoxication
  • * Known history of substantial cognitive impairment
  • * Known or suspected altered mental status due to traumatic brain injury
  • * Known active psychosis, suicidal ideation, or homicidal ideation
  • * Unable to use both hands (e.g. due to sprain)
  • * Any other history or condition that would, in the site investigator's judgement, indicate that the individual would very likely be non-compliant with the study or unsuitable for the study (e.g. might interfere with the study, confound interpretation, or endanger participant)

Ages Eligible for Study

18 Years to 50 Years

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

No

Collaborators and Investigators

University of North Carolina, Chapel Hill,

Samuel McLean, MD, MPH, PRINCIPAL_INVESTIGATOR, University of North Carollina at Chapel Hill

Study Record Dates

2027-03