Fully remote intensive trauma-focused treatment for PTSD and Complex PTSD

Abstract

Background: It is unknown whether remotely delivered intensive trauma-focused therapy not only is an effective treatment for PTSD, but also for Complex PTSD. Objective: Testing the hypothesis that a brief, fully remotely administered intensive trauma-focused treatment programme for individuals with PTSD and Complex PTSD would be safe, and associated with a significant decline of the corresponding symptoms and diagnostic status. Method: The treatment sample consisted of 73 consecutive patients diagnosed with PTSD according to the CAPS-5. According to the ITQ ( n = 70) 33 (47.1%) patients also fulfilled the diagnostic criteria of Complex PTSD. The 4-day treatment programme contained a combination of prolonged exposure, EMDR therapy, physical activities and psycho-education. Treatment response was measured using the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), the PTSD Checklist for DSM-5 (PCL-5), and the International Trauma Questionnaire (ITQ) for classifying Complex PTSD and indexing disturbances in self-organization (DSO). Results: Overall CAPS-5, PCL-5, and ITQ-DSO scores decreased significantly from pre- to post-treatment (Cohen’s ds 2.12, 1.59, and 1.18, respectively), while the decrease was maintained to six months follow-up. At post-treatment, 60 patients (82.2%) no longer met the diagnostic criteria of PTSD, while the proportion of patients with Complex PTSD decreased from 47.1% to 10.1%. No drop out, and no personal adverse events occurred. Conclusions: The results support the notion that intensive, trauma-focused treatment is feasible, safe and associated with a large decrease in PTSD and Complex PTSD symptoms, even when it is brief, and applied fully remote. HIGHLIGHTS Second study to examine the effectiveness of a fully remote intensive trauma-focused treatment for PTSD and Complex PTSD. Significant decrease of DSO symptoms. Over 80 percent of the patients no longer met the diagnostic criteria of PTSD and Complex PTSD following treatment.

Crises in the Anthropocene

“… 2. Fully remote intensive trauma-focused treatment for PTSD and Complex PTSD (Bongaerts et al, 2022 ) There is an urgent need for evidence about the effectiveness and safety of remote interventions for post-traumatic stress conditions, in particular after COVID-19 Pretty cool that you can do an intensive treatment fully remotely.. . Importance of testing the efficacy of online interventions for PTSD treatment.…”

Case report: Intensive online trauma treatment combining prolonged exposure and EMDR 2.0 in a patient with severe and chronic PTSD

“…In one case report ( 20 ) six patients suffering from PTSD (of which four with Complex PTSD; CPTSD) received four consecutive days of treatment and the results showed four of the six patient lost their PTSD or Complex PTSD diagnosis and scores on a PTSD interview (CAPS-5) and self-reported PTSD symptoms (PCL-5) decreased significantly. Research from the same treatment facility recently also showed in a sample of 73 patients that clinical (CAPS-5), self-reported (PCL-5), and Complex PTSD symptoms (International Trauma Questionnaire – Disturbances in Self Organization; ITQ-DSO) decreased and that 82,2% of the patients no longer met PTSD criteria ( 21 ). Interestingly also, in both studies no dropout and no adverse events occurred.…”

A randomized controlled trial of Deep Brain Reorienting: a neuroscientifically guided treatment for post-traumatic stress disorder

“…Here, we conducted an interim analysis of behavioural data gained through the first randomized clinical trial designed to assess the effectiveness of DBR therapy for individuals with PTSD, including those with childhood traumatization given its high correspondence with the later development of trauma-related conditions (Mikulincer et al, 2015 ; Ogle et al, 2015 ; Woodhouse et al, 2015 ). DBR sessions were internet-based via videoconferencing, an efficacious alternative to in-person psychotherapy for PTSD that accommodated COVID-19 restrictions (Bongaerts et al, 2022 ; Greenwood et al, 2022 ; Poletti et al, 2020 ). This interim investigation was conducted on PTSD severity scores pre – and post-DBR treatment for participants who have surpassed the three-month follow-up timepoint at the time of analysis, which was three years since the onset of the clinical trial.…”