Safety and effectiveness of intensive treatment for complex PTSD delivered via home-based telehealth

Abstract

Background: Home-based psychotherapy delivered via telehealth has not been investigated in the context of intensive trauma-focused treatment for individuals with severe or Complex posttraumatic stress disorder (PTSD). Objective: To examine the feasibility, safety and effectiveness of an intensive treatment programme containing prolonged exposure, EMDR therapy, physical activities and psychoeducation, delivered via home-based telehealth. Method: The treatment was carried out within four consecutive days during the outbreak of the COVID-19 pandemic. The sample consisted of six (four female) patients suffering from severe or Complex PTSD resulting from exposure to multiple traumatic events, mostly during early childhood. Four of them fulfilled the diagnostic criteria of complex PTSD. Outcome measures were the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), the PTSD Checklist for DSM-5 (PCL-5), and the International Trauma Questionnaire (ITQ). Results: CAPS-5 and PCL-5 scores decreased significantly from pre-to post-treatment (Cohen's ds 1.04 and 0.93), and from post-treatment to follow-up (Cohen's ds 0.92 and 1.24). Four of the six patients lost their PTSD or Complex PTSD diagnostic status. No patient dropped out, no personal adverse events and no reliable symptom worsening occurred. Conclusions:The results suggest that intensive, trauma-focused treatment of severe or Complex PTSD delivered via home-based telehealth is feasible, safe and effective, and can be a viable alternative to face-to-face delivered intensive trauma-focused treatment.

A Stage 1 Pilot Cohort Exploring the Use of EMDR Therapy as a Videoconference Psychotherapy During COVID-19 With Frontline Mental Health Workers: A Proof of Concept Study Utilising a Virtual Blind 2 Therapist Protocol

“…Currently, limited research publications support EMDR therapy, which uses VCP to treat post-traumatic stress disorder (PTSD) ( Todder et al, 2007 ; Todder and Kapln, 2007 ; Lightstone et al, 2015 ). However, a recent study ( Bongaerts et al, 2021 ) has used home-based psychotherapy, delivered by telehealth, as a treatment intervention for complex PTSD. The intervention was delivered in an intensive format, offering both prolonged exposure and eye movement desensitisation and reprocessing [EMDR therapy].…”

“…The intervention was delivered in an intensive format, offering both prolonged exposure and eye movement desensitisation and reprocessing [EMDR therapy]. Six participants took part in the study, with two-thirds losing their PTSD or complex-PTSD diagnostic status, demonstrating that the telehealth intervention was both safe and effective ( Bongaerts et al, 2021 ). However, the sample size in their study was small, with just six participants, and only four of the six losing their diagnosis.…”

“…As indicated earlier, within the existing EMDR therapy literature, there is a paucity of research regarding the use of VCP EMDR ( Bongaerts et al, 2021 ). In addressing this aspect, any potential study would have to address two significant aims:…”

Understanding the mental health impacts of COVID-19 through a trauma lens

“…Suggests that intensive, trauma-focused treatment of severe or Complex PTSD delivered via home-based telehealth is feasible, safe and effective, and can be a viable alternative to face-to-face delivered intensive trauma-focused treatment. (Bongaerts et al, 2021 ) Wild, J., Warnock-Parkes, E., Murray, H., Kerr, A., Thew, G., Grey, N., … & Ehlers, A. (2020).…”

“…The COVID-19 pandemic saw a sudden shift to telehealth for trauma-related mental health in countries where this was possible. A number of studies in this Special Issue investigated whether this was effective and satisfactory for patients (Bongaerts, Voorendonk, van Minnen, & de Jongh, 2021 ; ter Heide et al, 2021 ; Wild et al, 2020 ). This research is important because many clinics may be interested in maintaining a large focus on telehealth once the pandemic is brought under control.…”