Advances in PTSD Treatment Delivery: Review of Findings and Clinical Considerations for the Use of Telehealth Interventions for PTSD

Morland, Leslie A.; Wells, Stephanie Y.; Glassman, Lisa H.; Greene, Carolyn J.; Hoffman, Julia E.; Rosen, Craig S.

doi:10.1007/s40501-020-00215-x

Cited by 64 publications

(60 citation statements)

References 53 publications

(50 reference statements)

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“…Second, associations of distress with worry about pandemic effects on mental health underscore the need for public investment to reduce barriers to mental health care. As telehealth delivery is as effective as in-person delivery of evidence-based anxiety, depression, and PTSD treatments (Morland et al, 2020 ; Tuerk, Keller, & Acierno, 2018 ), expansion of these services is warranted. Resources to provide smart tablets, as successfully piloted by the Department of Veterans Affairs (Zulman et al, 2019 ), could expand access to low-income households where smart phone and laptop ownership are not universal (Nadkarni et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Mental health impact of the COVID-19 pandemic in U.S. military veterans: a population-based, prospective cohort study

Hill

Nichter

et al. 2021

Psychol. Med.

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Background: The coronavirus disease-2019 (COVID-19) pandemic has caused myriad health, social, and economic stressors. To date, however, no known study has examined changes in mental health during the pandemic in the U.S. military veteran population. Methods: Data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study, a nationally representative, prospective cohort survey of 3,078 veterans. Pre-to-peri-pandemic changes in psychiatric symptoms were evaluated, as well as pre-pandemic risk and protective factors and pandemic-related correlates of increased psychiatric distress. Results: The prevalence of generalized anxiety disorder (GAD) positive screens increased from pre-to peri-pandemic (7.1% to 9.4%; p<0.001) and was driven by an increase among veterans aged 45-64 years (8.2% to 13.5%; p<0.001), but the prevalence of major depressive disorder and posttraumatic stress disorder positive screens remained stable. Using a continuous measure of psychiatric distress, an estimated 13.2% of veterans reported a clinically meaningful pre-to-peri-pandemic increase in distress (mean=1.1 standard deviation). Veterans with a larger pre-pandemic social network size and secure attachment style were less likely to experience increased distress, whereas veterans reporting more pre-pandemic loneliness were more likely to experience increased distress.Concerns about pandemic-related social losses, mental health COVID-19 effects, and housing stability during the pandemic were associated with increased distress, over-and-above prepandemic factors. Conclusions: Although most U.S. veterans showed resilience to mental health problems nearly one year into the pandemic, the prevalence of GAD positive screens increased, particularly among middle-aged veterans, and 1-of-7 veterans experienced increased distress.Clinical implications of these findings are discussed.

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Section: Discussionmentioning

confidence: 99%

Mental health impact of the COVID-19 pandemic in U.S. military veterans: a population-based, prospective cohort study

Hill

Nichter

et al. 2021

Psychol. Med.

Self Cite

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“…Over the past decades, the effectiveness of telepsychiatry has been examined in numerous studies. With respect to treatment outcome, empirical evidence suggests that telepsychiatry is on a par with face-to-face treatment for various psychiatric disorders [ 19 ], including anxiety disorder [ 20 , 21 ], depression [ 21 ], and post-traumatic stress disorder [ 22 – 24 ]. Also, patients seem to be as satisfied with tele-mental health interventions as they are with in-person treatment ([ 25 ], see also e.g.…”

Section: Telepsychiatry Versus Face-to-face Therapymentioning

confidence: 99%

Treatment provision for adults with ADHD during the COVID-19 pandemic: an exploratory study on patient and therapist experience with on-site sessions using face masks vs. telepsychiatric sessions

et al. 2021

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Background Maintaining the therapeutic care of psychiatric patients during the first wave of the COVID-19 pandemic in Switzerland required changes to the way in which sessions were conducted, such as telepsychiatric interventions or using face masks during on-site sessions. While little is known about how face masks affect the therapeutic experience of patients and therapists, the effectiveness of telepsychiatry is well documented for several psychiatric disorders. However, research on the benefits of telepsychiatry in adult patients with attention-deficit/hyperactivity disorder (ADHD) remains scarce. This seems problematic since the symptoms typically associated with ADHD, such as attention problems and distractibility, may lessen the utility of telepsychiatry for this particular group. The present study’s aim was to explore how adult patients with ADHD and their therapists experienced therapy sessions during the COVID-19 pandemic in three different settings: face-to-face with the therapist wearing a face mask, via telephone, or via videoconferencing. Methods In this exploratory, quantitatively driven mixed-method study (quantitative questionnaire data and qualitative data from open-ended responses), we assessed patients’ evaluation of the session, their treatment satisfaction, and patients’ and therapists’ ratings of therapeutic alliance. We also collected qualitative comments on both sides’ experience of the session. Overall, 97 therapist and 66 patient questionnaires were completed. Results are reported for the N = 60 cases for which data from both parties were available. Sequential multiple regressions adjusted for therapist and number of sessions were used for the main quantitative analyses. Results No statistically significant differences regarding session flow, post-session positivity, satisfaction and therapeutic alliance were observed. The only exception was that telepsychiatric sessions were rated as significantly less deep than face-to-face sessions, an effect that may decline over time, especially in the videoconferencing group. Patients and therapists identified similar facilitating and complicating aspects, but differed in their emphasis of specific elements. Conclusions Both settings, on-site with the therapist wearing a face mask and telepsychiatric, seem to be valid options to continue treatment of adults with ADHD during a situation such as the COVID-19 pandemic. Aspects such as patient preference, session content, and therapeutic methods may be useful to identify the most suitable modality.

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“…perpetuity. preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in The copyright holder for this this version posted December 14, 2020. ; https://doi.org/10.1101/2020.12.11.20242511 doi: medRxiv preprint COVID-19: TREATMENT PROVISION FOR ADULTS WITH ADHD 7 21], depression [21], and post-traumatic stress disorder [22][23][24]. Also, patients seem to be as satisfied with tele-mental health interventions as they are with in-person treatment [25, see also e.g.…”

Section: Telepsychiatry Versus Face-to-face Therapymentioning

confidence: 99%

“…Over the past decades, the effectiveness of telepsychiatry has been examined in numerous studies. With respect to treatment outcome, empirical evidence suggests that telepsychiatry is on a par with face-to-face treatment for various psychiatric disorders [19], including anxiety disorder [20,21], depression [21], and post-traumatic stress disorder [22][23][24]. Also, patients seem to be as satisfied with tele-mental health interventions as they are with in-person treatment [25, see also e.g.…”

Section: Telepsychiatry Versus Face-to-face Therapymentioning

confidence: 99%

Treatment provision for adults with ADHD during the COVID-19 pandemic: An exploratory study on patient and therapist experience with on-site sessions using face masks vs. telepsychiatric sessions

Wyler

Liebrenz

Ajdacic-Gross

et al. 2020

Preprint

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BackgroundMaintaining the therapeutic care of psychiatric patients during the first wave of the COVID-19 pandemic in Switzerland required changes to the way in which sessions were conducted, such as telepsychiatric interventions or the use of face masks during on-site sessions. While little is known about how face masks affect the therapeutic experience of patients and therapists, the effectiveness of telepsychiatry is well documented for several psychiatric disorders. However, research on the benefits of telepsychiatry in adult patients with attention-deficit/hyperactivity disorder (ADHD) remains scarce. This seems problematic since the symptoms typically associated with ADHD, such as attention problems and distractibility, may lessen the utility of telepsychiatry for this particular group. The present study’s aim was to explore how adult patients with ADHD and their therapists experienced therapy sessions during the COVID-19 pandemic in three different settings: face-to-face with the therapist wearing a face mask, via telephone, or via videoconferencing.MethodsIn this exploratory, quantitatively driven mixed-method study (quantitative questionnaire data and qualitative data from open-ended responses), we assessed patients’ evaluation of the session, their treatment satisfaction, and patients’ and therapists’ ratings of therapeutic alliance. We also collected qualitative comments on both sides’ experience of the session. Overall, 97 therapist and 66 patient questionnaires were completed. Results are reported for the N = 60 cases for which data from both parties were available. Sequential multiple regressions adjusted for therapist and number of sessions were used for the main quantitative analyses.ResultsTelepsychiatric sessions were rated as significantly less deep than face-to-face sessions, an effect that was mainly driven by lower ratings in the videoconferencing group and, as suggested by further analyses, may decline over time. No other statistically significant differences were observed. Elements that were mentioned as facilitating or complicating a session differed markedly between patients and therapists.ConclusionsBoth settings, on-site with the therapist wearing a face mask and telepsychiatric, seem to be valid options to continue treatment of adults with ADHD during a situation such as the COVID-19 pandemic. Aspects such as patient preference, session content, and therapeutic methods may be useful to identify the most suitable modality.

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Advances in PTSD Treatment Delivery: Review of Findings and Clinical Considerations for the Use of Telehealth Interventions for PTSD

Cited by 64 publications

References 53 publications

Mental health impact of the COVID-19 pandemic in U.S. military veterans: a population-based, prospective cohort study

Mental health impact of the COVID-19 pandemic in U.S. military veterans: a population-based, prospective cohort study

Treatment provision for adults with ADHD during the COVID-19 pandemic: an exploratory study on patient and therapist experience with on-site sessions using face masks vs. telepsychiatric sessions

Treatment provision for adults with ADHD during the COVID-19 pandemic: An exploratory study on patient and therapist experience with on-site sessions using face masks vs. telepsychiatric sessions

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