TELEMEDICINE VERSUS IN-PERSON DELIVERY of COGNITIVE PROCESSING THERAPY for WOMEN with POSTTRAUMATIC STRESS DISORDER: A RANDOMIZED NONINFERIORITY TRIAL

Leslie A. Morland, Margaret Anne Mackintosh, Craig S. Rosen, Emy Willis, Patricia Resick, Kathleen Chard, B. Christopher Frueh

Research output: Contribution to journalArticle

61 Scopus citations

Abstract

Background This study examined the effectiveness of telemedicine to provide psychotherapy to women with posttraumatic stress disorder (PTSD) who might be unable to access treatment. Objectives were to compare clinical and process outcomes of PTSD treatment delivered via videoteleconferencing (VTC) and in-person (NP) in an ethnically diverse sample of veteran and civilian women with PTSD. Methods A randomized controlled trial of Cognitive Processing Therapy, an evidence-based intervention for PTSD, was conducted through a noninferiority design to compare delivery modalities on difference in posttreatment PTSD symptoms. Women with PTSD, including 21 veterans and 105 civilians, were assigned to receive psychotherapy delivered via VTC or NP. Primary treatment outcomes were changes in PTSD symptoms in the completer sample. Results Improvements in PTSD symptoms in the VTC condition (n = 63) were noninferior to outcomes in the NP condition (n = 63). Clinical outcomes obtained when both conditions were pooled together (N = 126) demonstrated that PTSD symptoms declined substantially posttreatment (mean = -20.5, 95% CI -29.6 to -11.4) and gains were maintained at 3- (mean = -20.8, 95% CI -30.1 to -11.5) and 6-month followup (mean = -22.0, 95% CI -33.1 to -10.9. Veterans demonstrated smaller symptom reductions posttreatment (mean = -9.4, 95% CI -22.5 to 3.7) than civilian women (mean = -22.7, 95% CI -29.9 to -15.5. Conclusions Providing psychotherapy to women with PTSD via VTC produced outcomes comparable to NP treatment. VTC can increase access to specialty mental health care for women in rural or remote areas.

Original languageEnglish (US)
Pages (from-to)811-820
Number of pages10
JournalDepression and Anxiety
Volume32
Issue number11
DOIs
StatePublished - Nov 2015

Keywords

  • CBT/cognitive behavior therapy
  • clinical trials
  • computer/internet technology
  • empirical supported treatment
  • trauma

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

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