Face to face but not in the same place: A pilot study of prolonged exposure therapy

Abstract

This pilot study examined use of smartphone technology to deliver prolonged exposure (PE) therapy to patients with posttraumatic stress disorder (PTSD) with geographic limitations hindering in-person therapy. The primary goal was to examine the feasibility and acceptability of using video teleconferencing (i.e., computer-based and iPhone 4 streaming technology), with a secondary goal of examining clinical outcomes of PE delivered via teleconferencing compared with treatment as usual (TAU) on PTSD and depressive/anxious symptom reduction. Rural veterans (N = 27) were randomized to receive PE by computer teleconferencing at a Veterans Administration community clinic, PE by an iPhone issued for the duration of the study, or TAU provided by a referring clinician. To examine the research goals, we collected data on the number of referrals to the study, number of patients entering the study, and number completing psychotherapy and documented pragmatic and technical issues interfering with the ability to use teleconferencing to deliver PE; results are discussed. In addition, measures of symptom change examined clinical outcomes. Results indicated decreases in PTSD symptoms in veterans who completed PE therapy via teleconferencing; however, there was significantly more attrition in these groups than in the TAU group.

Psychological and pharmacological interventions for posttraumatic stress disorder and comorbid mental health problems following complex traumatic events: Systematic review and component network meta-analysis

“…Ninety-four ( n = 6,158 participants) RCTs were included in meta-analyses across the primary and secondary outcomes. Eighteen RCTs ( n = 933 participants) of psychological interventions that measured the primary outcome with CAPS were included in the NMA [ 29 , 36 , 39 , 44 , 59 , 68 , 84 , 88 , 91 – 93 , 100 , 106 , 107 , 109 , 116 , 120 , 123 ]. The complex-trauma subgroups of the included studies were categorised as follows: post–combat deployment veterans (55 studies) [ 32 – 35 , 37 , 39 – 41 , 43 – 48 , 50 – 54 , 56 , 58 , 60 – 63 , 66 – 71 , 73 , 74 , 76 , 77 , 82 , 90 , 100 , 103 , 104 , 106 – 108 , 115 , 116 , 121 , 123 , 124 , 127 , 128 , ...…”

“…Fig 9 shows the network plot of combinations of treatment components for the primary outcome across the 18 studies included in the network [ 29 , 36 , 39 , 44 , 59 , 68 , 84 , 88 , 91 – 93 , 100 , 106 , 107 , 109 , 116 , 120 , 123 ]. MDs for the primary outcome by intervention component are shown in S6 Table .…”

“…We included 116 studies (115 papers) in the systematic review. Of these, 50 were conducted in hospital settings , 24 were delivered in a community setting , seven were delivered in military clinics for veterans or active military personnel [103][104][105][106][107][108][109], five were conducted in refugee camps [110][111][112][113][114], four used remote delivery via web-based or telephone platforms [115][116][117][118], four were conducted in specialist trauma clinics [119][120][121][122], two were delivered in home settings [123,124], and two were delivered in primary care clinics [125,126]; clinical setting was not reported in 17 studies [127][128][129][130][131][132][133][134][135][136][137][138][139][140][141][142][143].…”

Smartphone App for Management of Mental Disorder: Comment on Usefulness in Specific Case of Posttraumatic Stress Disorder

“…[2] It is accepted as a possible way for “face to face but not in the same place” technique. [3] The use of smartphone app for management is very interesting. [4] As noted by Menon et al .,[4] “mobile phone-based psychotherapies are a feasible and acceptable treatment option for patients with mental disorders.” The application might useful for many psychological disorders including to PTSD.…”

“…Miner et al .firstly reported the new smartphone app namely “PTSD Coach app”[5] and reported on feasibility, acceptability, and potential efficacy for management of PTSD. [3] In an experimental trial by Kuhn et al . using smartphone app could significantly improve in PTSD symptoms.…”