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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 ,
Jessica Smith ,
Megan J. Hobbs ,
Siobhan A. Loughnan ,
Maria Sharrock ,
Jill M. Newby ,
Gavin Andrews  and
Alison E. J. Mahoney Open the ORCID record for Alison E. J. Mahoney [Opens in a new window]
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
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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.

Keywords

anxietycognitive behaviour therapyeffectivenesse-healthonlinepost-traumatic stress disorder
Type
Brief Clinical Report
Information
Behavioural and Cognitive Psychotherapy , Volume 50 , Issue 6 , November 2022 , pp. 649 - 655
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the British Association for Behavioural and Cognitive Psychotherapies

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