Internet-delivered cognitive therapy for PTSD: a development pilot series
Background: Randomised controlled trials have established that face-to-face cognitive therapy for posttraumatic stress disorder (CT-PTSD) based on Ehlers and Clark's cognitive model of PTSD is highly effective and feasible with low rates of dropout. Access to evidence-based psychological treatm...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2016-11-01
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| Series: | European Journal of Psychotraumatology |
| Subjects: | |
| Online Access: | http://www.ejpt.net/index.php/ejpt/article/view/31019/49658 |
| _version_ | 1818585610901782528 |
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| author | Jennifer Wild Emma Warnock-Parkes Nick Grey Richard Stott Milan Wiedemann Lauren Canvin Harriet Rankin Emma Shepherd Ava Forkert David M. Clark Anke Ehlers |
| author_facet | Jennifer Wild Emma Warnock-Parkes Nick Grey Richard Stott Milan Wiedemann Lauren Canvin Harriet Rankin Emma Shepherd Ava Forkert David M. Clark Anke Ehlers |
| author_sort | Jennifer Wild |
| collection | DOAJ |
| description | Background: Randomised controlled trials have established that face-to-face cognitive therapy for posttraumatic stress disorder (CT-PTSD) based on Ehlers and Clark's cognitive model of PTSD is highly effective and feasible with low rates of dropout. Access to evidence-based psychological treatments for PTSD is insufficient. Several studies have shown that therapist-assisted treatment delivery over the Internet is a promising way of improving access to cognitive behavioural therapy interventions. Objective: To develop an Internet version of CT-PTSD that significantly reduces therapist contact time without compromising treatment integrity or retention rates. Methods: We describe the development of an Internet version of CT-PTSD. It implements all the key procedures of face-to-face CT-PTSD, including techniques that focus on the trauma memory, such as memory updating, stimulus discrimination and revisiting the trauma site, as well as restructuring individually relevant appraisals relating to overgeneralisation of danger, guilt, shame or anger, behavioural experiments and planning activities to reclaim quality of life. A cohort of 10 patients meeting DSM-IV criteria for PTSD worked through the programme, with remote guidance from a therapist, and they were assessed at pre- and post-treatment on PTSD outcome, mood, work and social adjustment and process measures. Results: No patients dropped out. Therapists facilitated the treatment with 192 min of contact time per patient, plus 57 min for reviewing the patient's progress and messages. Internet-delivered CT-PTSD was associated with very large improvements on all outcome and process measures, with 80% of patients achieving clinically significant change and remission from PTSD. Conclusions: Internet-delivered cognitive therapy for PTSD (iCT-PTSD) appears to be an acceptable and efficacious treatment. Therapist time was reduced to less than 25% of time in face-to-face CT-PTSD. Randomised controlled trials are required to evaluate systematically the acceptability and efficacy of iCT-PTSD. |
| first_indexed | 2024-12-16T08:39:49Z |
| format | Article |
| id | doaj.art-2cf7d9fe269f48349af907aada73f0c7 |
| institution | Directory Open Access Journal |
| issn | 2000-8066 |
| language | English |
| last_indexed | 2024-12-16T08:39:49Z |
| publishDate | 2016-11-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | European Journal of Psychotraumatology |
| spelling | doaj.art-2cf7d9fe269f48349af907aada73f0c72022-12-21T22:37:42ZengTaylor & Francis GroupEuropean Journal of Psychotraumatology2000-80662016-11-017011110.3402/ejpt.v7.3101931019Internet-delivered cognitive therapy for PTSD: a development pilot seriesJennifer Wild0Emma Warnock-Parkes1Nick Grey2Richard Stott3Milan Wiedemann4Lauren Canvin5Harriet Rankin6Emma Shepherd7Ava Forkert8David M. Clark9Anke Ehlers10 Department of Experimental Psychology, University of Oxford, Oxford, UK Department of Experimental Psychology, University of Oxford, Oxford, UK NIHR Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK NIHR Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK Department of Experimental Psychology, University of Oxford, Oxford, UK Department of Experimental Psychology, University of Oxford, Oxford, UK NIHR Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK Department of Experimental Psychology, University of Oxford, Oxford, UK Department of Experimental Psychology, University of Oxford, Oxford, UK Department of Experimental Psychology, University of Oxford, Oxford, UK Department of Experimental Psychology, University of Oxford, Oxford, UKBackground: Randomised controlled trials have established that face-to-face cognitive therapy for posttraumatic stress disorder (CT-PTSD) based on Ehlers and Clark's cognitive model of PTSD is highly effective and feasible with low rates of dropout. Access to evidence-based psychological treatments for PTSD is insufficient. Several studies have shown that therapist-assisted treatment delivery over the Internet is a promising way of improving access to cognitive behavioural therapy interventions. Objective: To develop an Internet version of CT-PTSD that significantly reduces therapist contact time without compromising treatment integrity or retention rates. Methods: We describe the development of an Internet version of CT-PTSD. It implements all the key procedures of face-to-face CT-PTSD, including techniques that focus on the trauma memory, such as memory updating, stimulus discrimination and revisiting the trauma site, as well as restructuring individually relevant appraisals relating to overgeneralisation of danger, guilt, shame or anger, behavioural experiments and planning activities to reclaim quality of life. A cohort of 10 patients meeting DSM-IV criteria for PTSD worked through the programme, with remote guidance from a therapist, and they were assessed at pre- and post-treatment on PTSD outcome, mood, work and social adjustment and process measures. Results: No patients dropped out. Therapists facilitated the treatment with 192 min of contact time per patient, plus 57 min for reviewing the patient's progress and messages. Internet-delivered CT-PTSD was associated with very large improvements on all outcome and process measures, with 80% of patients achieving clinically significant change and remission from PTSD. Conclusions: Internet-delivered cognitive therapy for PTSD (iCT-PTSD) appears to be an acceptable and efficacious treatment. Therapist time was reduced to less than 25% of time in face-to-face CT-PTSD. Randomised controlled trials are required to evaluate systematically the acceptability and efficacy of iCT-PTSD.http://www.ejpt.net/index.php/ejpt/article/view/31019/49658PTSDposttraumatic stress disordercognitive therapyInternet-based treatmenttrauma |
| spellingShingle | Jennifer Wild Emma Warnock-Parkes Nick Grey Richard Stott Milan Wiedemann Lauren Canvin Harriet Rankin Emma Shepherd Ava Forkert David M. Clark Anke Ehlers Internet-delivered cognitive therapy for PTSD: a development pilot series European Journal of Psychotraumatology PTSD posttraumatic stress disorder cognitive therapy Internet-based treatment trauma |
| title | Internet-delivered cognitive therapy for PTSD: a development pilot series |
| title_full | Internet-delivered cognitive therapy for PTSD: a development pilot series |
| title_fullStr | Internet-delivered cognitive therapy for PTSD: a development pilot series |
| title_full_unstemmed | Internet-delivered cognitive therapy for PTSD: a development pilot series |
| title_short | Internet-delivered cognitive therapy for PTSD: a development pilot series |
| title_sort | internet delivered cognitive therapy for ptsd a development pilot series |
| topic | PTSD posttraumatic stress disorder cognitive therapy Internet-based treatment trauma |
| url | http://www.ejpt.net/index.php/ejpt/article/view/31019/49658 |
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