Chinese My Trauma Recovery, A Web-Based Intervention for Traumatized Persons in Two Parallel Samples: Randomized Controlled Trial

Abstract

BackgroundGuided self-help interventions for PTSD (post-traumatic stress disorder) are a promising tool for the dissemination of contemporary psychological treatment.ObjectiveThis study investigated the efficacy of the Chinese version of the My Trauma Recovery (CMTR) website.MethodsIn an urban context, 90 survivors of different trauma types were recruited via Internet advertisements and allocated to a randomized controlled trial (RCT) with a waiting list control condition. In addition, in a rural context, 93 survivors mainly of the 2008 Sichuan earthquake were recruited in-person for a parallel RCT in which the website intervention was conducted in a counseling center and guided by volunteers. Assessment was completed online on a professional Chinese survey website. The primary outcome measure was the Post-traumatic Diagnostic Scale (PDS); secondary outcome measures were Symptom Checklist 90-Depression (SCL-D), Trauma Coping Self-Efficacy Scale (CSE), Post-traumatic Cognitive Changes (PCC), and Social Functioning Impairment (SFI) questionnaires adopted from the My Trauma Recovery website.ResultsFor the urban sample, findings indicated a significant group×time interaction in post-traumatic symptom severity (F 1,88=7.65, P=.007). CMTR reduced post-traumatic symptoms significantly with high effect size after one month of treatment (F 1,45=15.13, Cohen’s d=0.81, P<.001) and the reduction was sustained over a 3-month follow-up (F 1,45=17.29, Cohen’s d=0.87, P<.001). In the rural sample, the group×time interaction was also significant in post-traumatic symptom severity (F 1,91=5.35, P=.02). Post-traumatic symptoms decreased significantly after treatment (F 1,48=43.97, Cohen’s d=1.34, P<.001) and during the follow-up period (F 1,48=24.22, Cohen’s d=0.99, P<.001). Additional outcome measures (post-traumatic cognitive changes, depression) indicated a range of positive effects, in particular in the urban sample (group×time interactions: F 1,88=5.32-8.37, all Ps<.03), contributing to the positive evidence for self-help interventions. Differences in the effects in the two RCTs are exploratorily explained by sociodemographic, motivational, and setting feature differences between the two samples.ConclusionsThese findings give support for the short-term efficacy of CMTR in the two Chinese populations and contribute to the literature that self-help Web-based programs can be used to provide mental health help for traumatized persons.Trial RegistrationAustralia New Zealand Clinical Trials Registry (ANZCTR): ACTRN12611000951954; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12611000951954 (Archived by WebCite at http://www.webcitation.org/6G7WyNODk).

Self-help interventions for adjustment disorder problems: a randomized waiting-list controlled study in a sample of burglary victims

“…The observed small effects on anxiety and stress symptoms are in line with published meta-analyses of pure self-help interventions for anxiety and depression (Cuijpers et al, 2011;Spek et al, 2007). There was a medium effect size for the reduction in symptoms of post-traumatic stress; this was more similar to the reported effects of web-based self-help interventions for traumatized participants (Hirai & Clum, 2005;Wang et al, 2013) than to the effects found in the bibliotherapeutic study by Ehlers et al (2003). Bibliotherapy may be better suited to treat AjD problems than PTSD and supports our hypothesis that AjD, under its new definition as a stress response disorder, may be a particularly suitable target for self-guided, low-threshold interventions.…”

“…Despite this evidence of the clinical potential of such interventions, few studies investigated the effectiveness of self-help interventions to treat stress-related disorders such as post-traumatic stress disorder (PTSD) and AjD. Internet-based self-help interventions were effective in reducing symptoms of post-traumatic stress (Hirai & Clum, 2005;Wang, Wang, & Maercker, 2013), but a self-help booklet did not achieve a reduction of PTSD, although participants subjectively rated it to be a helpful intervention (Ehlers et al, 2003). It is possible that the inclusion of interactive elements in electronic self-help interventions, such as automated feedback or movie sequences, are responsible for the higher effectiveness of e-interventions.…”

Systematic Review on Post-Traumatic Stress Disorder Among Survivors of the Wenchuan Earthquake

“…Z. Wang, Wang, and Maercker (2013) developed the Chinese My Trauma Recovery approach, a web-based intervention strategy to provide mental health help for traumatized persons. Short-term cognitive-behavioral therapy (CBT) group intervention represents a robust intervention for natural disaster victims (Y.…”

Internet-delivered cognitive behavioural therapy in the treatment of psychiatric illness

“…For example, for RCTs of Internet-delivered CBT in rural Scotland and China, computers had to be provided or computer centres created to allow patients to complete the program. 43,64 In addition, patients who are not technologically savvy may resist replacing clinical visits with computerized treatments.…”