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.

Keywords:

• ECT
• trauma
• mental health

Acknowledgement

The authors are grateful to the participants and the user representative group for their contributions. Thanks to Mette Ellingsdalen for feedback on the interview guide and assistance with interviewing participants. Thanks also to Rob Solveig Bartun and Monica Ørbakk for contributing to the discussions in the reference group.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The study was supported by DAM Health Rehabilitation Foundation grant [2017/43214].

Notes on contributors

Alina Coman

Alina Coman is a research psychologist and a Postdoctoral fellow at the Centre for medical ethics, University of Oslo. Her research takes an empirical ethics approach to explore the implications of neurotechnologies for treating mental disorders.

Hilde Bondevik

Hilde Bondevik is an intellectual historian and Professor of Medical and health humanities at the Department of Interdisciplinary health sciences, University of Oslo. Her research activity has focused especially on the gender aspects of health care, medical history and philosophy of science.