An intervention for climate related distress

All you need to know about the world's first RCT evaluating treatment effects on climate change related distress.

Welcome back to Climate Psyched! Or if you’ve just made your way here: Welcome! Climate Psyched is a monthly newsletter that explores all things related to psychology, emotions, behavior and the climate (and its related) crises together with us.

Tomorrow marks the opening of COP28, which will be held in Dubai, United Arab Emirates. It’s even before it’s start been surrounded by scandals such as the COP28 president (an oil exec!) wanting to use the meeting to close new oil and gas deals. And I think that’s about all I feel like saying about the meeting at this point. I hope to have a brighter outlook on it in a few weeks.

On a more uplifting note: Last week I was part of organizing a national conference on the broad topic of climate psychology, featuring various scientists presenting research on for example normativity in climate related emotions, factors that influence support for environmental policies and how people react to extreme weather events.

But one of the most exciting talks was on the recently published article Tailored internet-delivered cognitive behavioral therapy for individuals experiencing psychological distress associated with climate change: A pilot randomized controlled trial, written by a research group at Linköping University, here in Sweden. It’s, as far as we know, the first ever randomized controlled study on an intervention directed at climate related distress, and I feel like it deserves a thorough presentation.

Situation

Several studies have in recent years looked at the prevalence of climate related emotions and distress, noting that it’s a common phenomenon and one that should be taken seriously due to it’s heavy effect on people - not the least younger ones. This emotional distress can be seen in both people who are directly and indirectly affected by consequences of climate change.

Even though the research on climate and eco related emotions has been advancing substantially in recent years, there’s still a lack of interventional studies that evaluates the effects of treatment methods and other interventions. This study is the first randomized controlled study looking at treatment effects.

Let’s look at what the researchers did and what they found.

Explanation

The research group designed an individually tailored internet-delivered cognitive behavioral therapy (ICBT) that focused on psychological symptoms associated with climate change and consequences of the climate crisis.

The individual tailoring meant that each participant were able to choose a number of modules in their own preferred order, as opposed to all participants following the exact same program. Individual tailoring has the advantage of adapting to each patient’s specific challenges and symptoms. The researchers write that in the context of climate change, an individually tailored treatment can be beneficial since people can experience climate related distress in many different ways.

60 participants, 77% women (mean age = 41 years), were recruited and offered eight weeks of therapist-guided ICBT. Half of them received the treatment immediately, while the other half were put on a waiting list and received the treatment 10 weeks later. All participants filled out self-reports before and after the intervention, which allowed the research group to evaluate changes in symptoms of depression, anxiety and stress, as well as insomnia, overall health, perceived quality of life, environmental action and how well participants were coping with climate related emotions and distress.

Only participants over 18 years, who experienced psychological symptoms related to climate change and that had no ongoing substance abuse, other psychological treatment or acute suicidality were included in the study.

Treatment

The treatment consisted of 15 modules, out of which each participant was granted access to eight. All participants were assigned the first module, “Introduction”, and the last module, “Conclusion and maintenance plan”. Example of the other modules were “Nature connectedness”, “Acceptance”, “Self-compassion” and “Behavioral activation”. The modules included informative texts and CBT-exercises and each participant was granted access to one module per week, and encouraged to work independently with the modules’ material. Each participant was assigned a therapist and offered online support and feedback via text-message at least once a week.

One difference to some other CBT treatments was that this intervention was explicit in not questioning the reality of the climate crisis or encouraging participants to expand their carbon footprint. There was no focus on reducing negative thoughts about the impact of climate change, but rather the treatment focused on encouraging participants to act in line with their values and finding new ways of coping with difficult emotions.

Results

When comparing scores between the treatment group and control group, between pre- and post measures, the research group could conclude that the treatment had been effective in decreasing the following (with moderate to large effect sizes):

• Depressive symptoms

• Stress

• Climate related distress
  

  as well as increasing
  

• Quality of life

They could also see that the most prevalent symptoms were the depressive ones, which brings up the question of whether we’re, when talking about climate anxiety, might be missing what perhaps could be framed as climate depression. It also calls for a continuous focus on a wider range of climate related emotions and their various effect on people.

Interestingly, while the psychological distress decreased, there was no significant change on the measure of self-reported pro-environmental behavior, meaning that the participants continued to take action, at the same time as they increased their quality of life. This implicates that there’s no opposition between reducing climate related distress and keeping up with one’s climate related actions.

Action

There are a few key take away messages from the study:

• Climate related distress is not pathological in itself, but it can become pathological for some individuals. For those that are heavily affected it’s important for professionals to have good knowledge and efficient methods to be able to help out in a good way.

• Decreased psychological climate distress does not mean decreased pro-environmental behavior. This is good news, not the least do address whether it’s necessary to feel climate anxiety to be able to take climate action.

• It’s surprising how few studies on climate related emotions and distress that thus far have explored and evaluated different treatments or interventions. This study adds a piece of knowledge, that will hopefully continues to be explored in future research studies.

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Let us know you’re thoughts on this recent study, about addressing climate related distress with CBT and about how to balance between not pathologising adequate emotional responses to climate changeand not neglecting those so impacted that there’s a genuine need for interventions or even psychological treatments.

Hope you enjoyed this edition of Climate Psyched - as always, feel free to share it to others who might be interested, and give us a like to make this post visible to more people! See you in December - I have a fun text coming up for you all.