Article2019

Videoconferencing psychotherapy for veterans with PTSD: Results from a randomized controlled non-inferiority trial

Lin Liu · Steven R. Thorp · Lucy Moreno · Stephanie Y. Wells · Lisa Hayley Glassman · Angela Christina Busch +5 more

70 citations0/0 files storedJournal of Telemedicine and Telecare

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Posttraumatic Stress Disorder Research Telemedicine and Telehealth Implementation Psychotherapy Techniques and Applications

Abstract

INTRODUCTION: Veterans with post-traumatic stress disorder (PTSD) face significant barriers that make it less likely for them to pursue treatment. A randomized controlled non-inferiority trial was used to determine if providing psychotherapy for PTSD via videoconference (VC) is as effective as in-person (IP) psychotherapy. METHODS: = 207) received cognitive processing therapy (CPT) to treat PTSD symptoms in one of the two treatment modalities. Participant symptoms were collected at baseline, post-treatment, and six months after treatment completion. The primary outcome measure, the Clinician-Administered PTSD Scale (CAPS), was used to assess PTSD diagnosis and symptom severity. Secondary outcomes included two self-report measures of symptom severity, the Post-traumatic Stress Disorder Checklist - Specific (PCL-S) for PTSD and the Patient Health Questionnaire - 9 (PHQ-9) for depressive symptoms. A linear mixed-effects model was used to assess non-inferiority for participants who completed treatment (completers) and those who were randomized to treatment (intention-to-treat (ITT)). RESULTS: Both completer and ITT analyses showed that improvement in CAPS scores in the VC condition was non-inferior to that in the IP condition at six-month follow-up, but VC was inferior to IP for improvement in CAPS at post-treatment. Non-inferiority was supported by completer analyses for PCL-S and PHQ-9 in both post-treatment change and six-month follow-up change, and the ITT analysis supported the significant non-inferiority for PCL at post-treatment change. DISCUSSION: These findings generally suggest that CPT delivered via VC can be as effective as IP for reducing the severity of PTSD symptoms.

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References

2001The PHQ-9 2001Clinician-administered PTSD scale: A review of the first ten years of research 2017The Clinician-Administered PTSD Scale for DSM–5 (CAPS-5): Development and initial psychometric evaluation in military veterans.1990A clinician rating scale for assessing current and lifetime PTSD. The CAPS-1 n.d.Cognitive processing therapy for PTSD a comprehensive manual 2013Meta-analysis of dropout in treatments for posttraumatic stress disorder.2010Prevalence Estimates of Combat-Related Post-Traumatic Stress Disorder: Critical Review 2009A Qualitative Study of Determinants of PTSD Treatment Initiation in Veterans

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