Hostname: page-component-848d4c4894-hfldf Total loading time: 0 Render date: 2024-05-24T23:01:43.263Z Has data issue: false hasContentIssue false

Internet-delivered cognitive behaviour therapy for post-traumatic stress disorder: a randomised controlled trial and outcomes in routine care

Published online by Cambridge University Press:  04 August 2022

Adrian R. Allen
Affiliation:
Clinical Research Unit for Anxiety and Depression, St Vincent’s Hospital, 390 Victoria Street, Darlinghurst, Sydney, New South Wales, 2010, Australia
Jessica Smith
Affiliation:
Clinical Research Unit for Anxiety and Depression, St Vincent’s Hospital, 390 Victoria Street, Darlinghurst, Sydney, New South Wales, 2010, Australia Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, UK
Megan J. Hobbs
Affiliation:
Clinical Research Unit for Anxiety and Depression, St Vincent’s Hospital, 390 Victoria Street, Darlinghurst, Sydney, New South Wales, 2010, Australia
Siobhan A. Loughnan
Affiliation:
Clinical Research Unit for Anxiety and Depression, St Vincent’s Hospital, 390 Victoria Street, Darlinghurst, Sydney, New South Wales, 2010, Australia
Maria Sharrock
Affiliation:
Clinical Research Unit for Anxiety and Depression, St Vincent’s Hospital, 390 Victoria Street, Darlinghurst, Sydney, New South Wales, 2010, Australia
Jill M. Newby
Affiliation:
School of Psychology, Faculty of Science, University of New South Wales, Sydney, NSW, 2052, Australia Black Dog Institute, Hospital Road, Randwick, NSW, 2031, Australia
Gavin Andrews
Affiliation:
Clinical Research Unit for Anxiety and Depression, St Vincent’s Hospital, 390 Victoria Street, Darlinghurst, Sydney, New South Wales, 2010, Australia School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
Alison E. J. Mahoney*
Affiliation:
Clinical Research Unit for Anxiety and Depression, St Vincent’s Hospital, 390 Victoria Street, Darlinghurst, Sydney, New South Wales, 2010, Australia School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
*
*Corresponding author. Email: alison.mahoney@svha.org.au

Abstract

Background:

Despite its potential scalability, little is known about the outcomes of internet-based cognitive behaviour therapy (iCBT) for post-traumatic stress disorder (PTSD) when it is provided with minimal guidance from a clinician.

Aim:

To evaluate the outcomes of minimally guided iCBT for PTSD in a randomised control trial (RCT, Study 1) and in an open trial in routine community care (Study 2).

Method:

A RCT compared the iCBT course (n=21) to a waitlist control (WLC, n=19) among participants diagnosed with PTSD. The iCBT group was followed up 3 months post-treatment. In Study 2, treatment outcomes were evaluated among 117 adults in routine community care. PTSD symptom severity was the primary outcome in both studies, with psychological distress and co-morbid anxiety and depressive symptoms providing secondary outcomes.

Results:

iCBT participants in both studies experienced significant reductions in PTSD symptom severity from pre- to post-treatment treatment (within-group Hedges’ g=.72–1.02), with RCT findings showing maintenance of gains at 3-month follow-up. The WLC group in the RCT also significantly improved, but Study 1 was under-powered and the medium between-group effect favouring iCBT did not reach significance (g=0.64; 95% CI, –0.10–1.38).

Conclusions:

This research provides preliminary support for the utility of iCBT for PTSD when provided with minimal clinician guidance. Future studies are needed to clarify the effect of differing levels of clinician support on PTSD iCBT outcomes, as well as exploring how best to integrate iCBT into large-scale, routine clinical care of PTSD.

Type
Brief Clinical Report
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the British Association for Behavioural and Cognitive Psychotherapies

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Hirai, M., & Clum, G. A. (2005). An internet-based self-change program for traumatic event related fear, distress, and maladaptive coping. Journal of Traumatic Stress, 18, 631636. doi.org/10.1002/jts.20071 CrossRefGoogle ScholarPubMed
Lewis, C., Roberts, N. P., Simon, N., Bethell, A., & Bisson, J. I. (2019). Internet-delivered cognitive behavioural therapy for post-traumatic stress disorder: systematic review and meta-analysis. Acta Psychiatrica Scandinavica, 140, 508521. doi.org/10.1111/acps.13079 CrossRefGoogle ScholarPubMed
McLean, C. P., Levy, H. C., Miller, M. L., & Tolin, D. F. (2022). Exposure therapy for PTSD: a meta-analysis. Clinical Psychology Review, 91, 102115. https://doi.org/10.1016/j.cpr.2021.102115 CrossRefGoogle ScholarPubMed
Newby, J. M., Mason, E., Kladnistki, N., Murphy, M., Millard, M., Haskelberg, H., & Mahoney, A. (2021). Integrating internet cognitive behavioural therapy into routine clinical practice: a guide for clinicians. Clinical Psychologist, 115. doi.org/10.1080/13284207.2020.1843968 Google Scholar
Resick, P. A., Monson, C. M., & Chard, K. M. (2008). Cognitive processing therapy: Veteran/military version. Washington, DC, USA: Department of Veterans’ Affairs Google Scholar
Ruwaard, J., Lange, A., Schrieken, B., Dolan, C. V., & Emmelkamp, P. (2012). The effectiveness of online cognitive behavioral treatment in routine clinical practice. PLoS One, 7, e40089. doi.org/10.1371/journal.pone.0040089 CrossRefGoogle ScholarPubMed
Supplementary material: File

Allen et al. supplementary material

Allen et al. supplementary material

Download Allen et al. supplementary material(File)
File 301.3 KB
Submit a response

Comments

No Comments have been published for this article.