Internet-based interventions for traumatic stress-related mental health problems: A review and suggestion for future research

Abstract

Exposure to potentially traumatic events is a common occurrence. Most individuals exposed to such an event are resilient or recover rapidly, although some individuals develop psychological problems that warrant treatment. However, a small percentage of individuals seek traditional treatment, thereby calling for novel approaches or methodologies of treatment. The present paper provides a comprehensive and critical review of the extant literature on computerized and internet-basedinterventions (IBIs) for traumatic stress related conditions (i.e., panic disorder, posttraumatic stress disorder/complicated grief, depression, comorbid anxiety and depression, alcohol abuse, smoking cessation). Generally, computerized or IBIs for depression and anxiety are yielding effect sizes that are comparable to traditional psychosocial treatment. Interventions aimed at alcohol and smoking cessation generally have lower effect sizes than do IBIs for anxiety and depression. Most interventions reviewed in this paper included common components (e.g., were developed through a cognitive behavioral framework and included psychoeducation, cognitive restructuring, goal setting, exposure). Therefore, it is possible that these shared features may in part account for symptom reduction. Little is known regarding mechanisms of change. Future directions for novel web-based approaches to treatment are provided.

Internet-based guided self-help for posttraumatic stress disorder (PTSD): Randomized controlled trial

“…'Interapy' showed promise for the treatment of sub-threshold PTSD symptoms, but was not evaluated within a population with a formalised diagnosis of PTSD (Amstadter, Broman-Fulks et al 2009). Within a clinical population, the first published RCT evaluated internet-based CBT in comparison to internet-based supportive counselling (Litz, Engel et al 2007).…”

“…This, combined with additional barriers to treatment including the perceived stigma associated with psychological therapy (Cuijpers, van Straten et al 2008) and inadequate service provision in rural areas (Griffiths and Christensen 2007), has resulted in long waiting times (Hitt, Kitchiner et al 2004) and low rates of treatment uptake (Norris, Kaniasty et al 1990, Hoge, Castro et al 2004). In response, there has been a growing interest in using the internet as a platform for the delivery of psychological therapy (Amstadter, Broman-Fulks et al 2009). Using the internet to deliver evidence-based treatment has the capacity to reduce the cost of effectively delivering evidence-based therapy (Hedman, Andersson et al 2011) and has the potential to overcome many other barriers that currently limit the availability and uptake of treatment (Griffiths, Lindenmeyer et al 2006).…”

E-mental health preferences of Veterans with and without probable posttraumatic stress disorder

“…Mental health providers' direct clinical involvement in self-guided Internet interventions varies greatly, and most current interventions are used as adjunct to or in lieu of traditional psychotherapy. Researchers who have evaluated online mental health interventions have found that they have the potential to be as effective as in-person services for a range of difficulties, including PTSD and other postdeployment problems [25].…”

New Frontiers in Healthcare and Technology: Internet-and Web-Based Mental Options Emerge to Complement In-Person and Telepsychiatric Care Options

“…Internetbased cognitive therapy (CT) is often combined with text messages (mobile cognitive therapy; mCT) and therapist e-mail and telephone contact -this prevents relapse in depression, is acceptable and is feasible for both patients and therapists [93]. Online MH interventions are also as effective as traditional in-person therapy for disorders such as depression and anxiety [94][95][96][97]. In a 30-month study using CBT for social phobia research, the long-term effects of in-person delivered CBT was comparable to Internet-based treatment [97].…”