Utilizing Telehealth to Support Treatment of Acute Stress Disorder in a Theater of War: Prolonged Exposure via Clinical Videoconferencing

PeltonDan,; WangelinBethany,; TuerkPeter,

doi:10.1089/tmj.2014.0111

Cited by 17 publications

(8 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A number of recommendations were identified to support the use of digital health to deliver evidence-based psychotherapy to military members, veterans, and PSP. Key recommendations included (1) identify and manage technological issues that may impede the use of digital health [ 25 , 88 ], (2) supplement interventions to increase patient comfort [ 75 , 87 ], (3) consider ways to establish and maintain rapport and trust [ 77 , 89 ], (4) be flexible and provide additional support as needed to facilitate progress and commitment to therapy [ 71 , 77 , 85 ], (5) review previously established standards and practices of delivering certain psychotherapeutic interventions to improve suitability for digital delivery [ 71 , 87 ], (6) address risk and safety issues [ 88 ], (7) understand and accommodate demographic factors that can influence the client experience of clients using digital health [ 62 , 90 ], and finally (8) support therapists through training to promote their effective use and uptake of digital health [ 80 , 84 ]. Specific findings related to these key themes are presented in Table 4 .…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Virtual Trauma-Focused Therapy for Military Members, Veterans, and Public Safety Personnel With Posttraumatic Stress Injury: Systematic Scoping Review

Jones¹,

Miguel-Cruz²,

Smith-MacDonald³

et al. 2020

JMIR Mhealth Uhealth

View full text Add to dashboard Cite

Background A necessary shift from in-person to remote delivery of psychotherapy (eg, teletherapy, eHealth, videoconferencing) has occurred because of the COVID-19 pandemic. A corollary benefit is a potential fit in terms of the need for equitable and timely access to mental health services in remote and rural locations. Owing to COVID-19, there may be an increase in the demand for timely, virtual delivery of services among trauma-affected populations, including public safety personnel (PSP; eg, paramedics, police, fire, correctional officers), military members, and veterans. There is a lack of evidence on the question of whether digital delivery of trauma-therapies for military members, veterans, and PSP leads to similar outcomes to in-person delivery. Information on barriers and facilitators and recommendations regarding digital-delivery is also scarce. Objective This study aims to evaluate the scope and quality of peer-reviewed literature on psychotherapeutic digital health interventions delivered remotely to military members, veterans, and PSP and synthesize the knowledge of needs, gaps, barriers to, and facilitators for virtual assessment of and virtual interventions for posttraumatic stress injury. Methods Relevant studies were identified using MEDLINE (Medical Literature Analysis and Retrieval System Online), EMBASE (Excerpta Medica dataBASE), APA (American Psychological Association) PsycINFO, CINAHL (Cumulative Index of Nursing and Allied Health Literature) Plus with Full Text, and Military & Government Collection. For collation, analysis, summarizing, and reporting of results, we used the CASP (Critical Skills Appraisal Program) qualitative checklist, PEDro (Physiotherapy Evidence Database) scale, level of evidence hierarchy, PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews), and narrative synthesis. Results A total of 38 studies were included in this review. Evidence for the effectiveness of digital delivery of prolonged exposure therapy, cognitive processing therapy, behavioral activation treatment with therapeutic exposure to military members, veterans, and PSP was rated level 1a, whereas evidence for cognitive behavioral therapy was conflicting. The narrative synthesis indicated that virtual delivery of these therapies can be as effective as in-person delivery but may reduce stigma and cost while increasing access to therapy. Issues of risk, safety, potential harm (ie, suicidality, enabling avoidance), privacy, security, and the match among the therapist, modality, and patient warrant further consideration. There is a lack of studies on the influences of gender, racial, and cultural factors that may result in differential outcomes, preferences, and/or needs. An investigation into other therapies that may be suitable for digital delivery is needed. Conclusions Digital delivery of trauma therapies for military members, veterans, and PSP is a critical area for further research. Although promising evidence exists regarding the effectiveness of digital health within these populations, many questions remain, and a cautious approach to more widespread implementation is warranted.

show abstract

Section: Resultsmentioning

confidence: 99%

“…“Given the high amount of turnover and transition among providers within and between deployments, it is imperative that all providers using [clinical videoconferencing] technology be briefed prior to, or at the beginning of, deployment.” [ 80 ]…”

Section: Resultsmentioning

confidence: 99%

Virtual Trauma-Focused Therapy for Military Members, Veterans, and Public Safety Personnel With Posttraumatic Stress Injury: Systematic Scoping Review

Jones¹,

Miguel-Cruz²,

Smith-MacDonald³

et al. 2020

JMIR Mhealth Uhealth

View full text Add to dashboard Cite

show abstract

“…Studies on telehealth, telecommunications technology that offers long-distance clinical services, emphasize the accessibility and flexibility they offer for patients (Lindsay et al, 2016; Ohl et al, 2014). Telehealth sessions with similar efficacy as in-person treatment (Yuen et al, 2015) can be provided to areas with no physical medical services available, such the rural parts of the country (Ohl et al, 2014) or abroad in conflict zones (Pelton, Wangelin, & Tuerk, 2015). Other studies show how eHealth platforms assist with communication with health providers for monitoring purposes (Kasckow et al, 2015) or part of motivational interviewing programs (Battaglia, Benson, Cook, & Prochazka, 2013).…”

Section: Better Health Via the Internetmentioning

confidence: 99%

The Digital Divide and Veterans’ Health: Differences in Self-Reported Health by Internet Usage

Swed

Sheehan

Butler

2018

Armed Forces & Society

View full text Add to dashboard Cite

The digital divide's implications on health inequality among American Military veterans has been discussed extensively in research; however, it remains unclear what is the association between Internet usage and health specifically among Veterans. We examine this question by addressing the growing digital gaps in the veteran population, looking at the association of Internet use and self-reported health. Using the National Survey of Veterans we find that compared to those who use the Internet daily, those who use the Internet less frequently have significantly higher odds of reporting “fair” or “poor” self-rated health. The significant association remained when demographic, socioeconomic, and military factors were controlled. While our results indicate that veterans that use the Internet more frequently report more favorable self-reported health, given our data we are unable to distinguish a causal relationship. We conclude by discussing potential policy interventions, targeting helping those who are left behind.

show abstract

“…3,4 Investigations of these procedures in numerous settings and populations exist and include research on participants in rural areas, older adults in communitydwellings, ethnoracial minorities, participants adjudicated by the courts, active duty military in a theatre of war, and veteran populations. [5][6][7][8][9][10][11] One condition that has received much attention in the telehealth literature is posttraumatic stress disorder (PTSD), due in large part to efforts by the Department of Veterans Affairs and the Department of Defense. 1 Along with its popularity in expanding coverage areas and related patient access to care, delivering EBPs for PTSD via telehealth is accompanied by support for their efficacy and effectiveness.…”

Section: Introductionmentioning

confidence: 99%

“…3,4 Investigations of these procedures in numerous settings and populations exist and include research on participants in rural areas, older adults in community-dwellings, ethnoracial minorities, participants adjudicated by the courts, active duty military in a theatre of war, and veteran populations. 5–11…”

Section: Introductionmentioning

confidence: 99%

Treatment satisfaction of home-based telehealth versus in-person delivery of prolonged exposure for combat-related PTSD in veterans

et al. 2016

View full text Add to dashboard Cite

Introduction Although there is growing support that evidence-based psychotherapies (EBPs) delivered in-person and through telehealth are equivalent in terms of symptom reduction for posttraumatic stress disorder (PTSD), there has been far less investigation comparing these treatment modalities in terms of patient satisfaction. The present study investigated participant satisfaction and perception of the quality of service delivery within a clinical trial comparing the delivery of an EBP, Prolonged Exposure (PE) for PTSD, through home-based telehealth and in-person services. Methods Veterans ( N = 67) with PTSD were randomized to receive PE via video telehealth technology ( n = 27) or via in-person delivery ( n = 40). Participants completed service demographic questions, PTSD symptom assessments, and satisfaction and service delivery perception questionnaires. Results Analyses of covariance were used to investigate the influence of treatment modality on patient satisfaction and perceived quality of service delivery, while controlling for demographics and PTSD symptoms. No differences were observed on the majority of measures, with the exception of participants in the telehealth condition endorsing willingness to drive further for telehealth services as compared with participants in the in-person condition. Discussion Findings illustrate participant satisfaction and acceptance of EBPs delivered via telehealth at a level consistent with that of in-person services. Preliminary findings suggest that the experience of receiving telehealth services may be associated with increased willingness to participate in telehealth services again. Together, these findings of patient satisfaction and acceptance of telehealth services support the ongoing delivery of EBPs via telehealth as well as their future expansion.

show abstract

Utilizing Telehealth to Support Treatment of Acute Stress Disorder in a Theater of War: Prolonged Exposure via Clinical Videoconferencing

Cited by 17 publications

References 34 publications

Virtual Trauma-Focused Therapy for Military Members, Veterans, and Public Safety Personnel With Posttraumatic Stress Injury: Systematic Scoping Review

Virtual Trauma-Focused Therapy for Military Members, Veterans, and Public Safety Personnel With Posttraumatic Stress Injury: Systematic Scoping Review

The Digital Divide and Veterans’ Health: Differences in Self-Reported Health by Internet Usage

Treatment satisfaction of home-based telehealth versus in-person delivery of prolonged exposure for combat-related PTSD in veterans

Contact Info

Product

Resources

About