Electroconvulsive Therapy (ECT) Referral Workshop for Depression: Assessing Patients and Addressing Stigma

Electroconvulsive therapy (ECT) is an important somatic treatment in psychiatry with well-defined indications, strong evidence for a quick response, and established efficacy. Despite the benefits of ECT, it is underutilized and inequitably accessed by patients in the United States. Patient and provider lack of knowledge, misinformation, and negative attitudes perpetuated by bias and stigma towards ECT can be significant barriers to patients receiving ECT.

We created a workshop to address these issues with Kern's six-step approach, using the affective context learning theory as a conceptual framework. Based on a literature review and ECT physician researcher expertise, we taught the 90-minute workshop to 50 psychiatry and other behavioral health trainees to assess patients for ECT referral and address stigma and bias towards ECT. The workshop was delivered in person at four separate sessions to a total of 50 trainees and included pre- and postworkshop assessments of workshop efficacy.

Results of a paired-samples t test of participants' responses pre- and postworkshop showed statistically significant growth on most learning objectives. Comments from the qualitative feedback indicated a majority-positive participant response to the engaging and effective workshop design and presentation. Participants' self-assessment found at least a 50% normalized gain for all learning objectives.

This workshop is an effective contribution to ECT educational scholarship that can build trainee confidence in assessing patients with depression for ECT referral and addressing ECT stigma in clinical care.