Distance-delivered interventions for PTSD: A systematic review and meta-analysis. (December 2016)

• Record Type: Journal Article
• Authors: Olthuis, Janine V.; Wozney, Lori; Asmundson, Gordon J.G.; Cramm, Heidi; Lingley-Pottie, Patricia; McGrath, Patrick J.
• Is Part Of: Journal of anxiety disorders. Volume 44(2016:Dec.)
• Page Start: 9
• Page End: 26
• Publication Date: 2016-12
• Subjects: Distance delivery -- Internet -- Posttraumatic stress disorder -- Treatment -- Videoconferencing; Anxiety -- Periodicals; Anxiety Disorders -- Periodicals; Angoisse -- Périodiques; Electronic journals; 616.8522
• DOI: 10.1016/j.janxdis.2016.09.010
• Languages: English
• ISSNs: 0887-6185

Abstract

Highlights: Distance CBT significantly reduced PTSD at post-treatment and follow-up. Post-treatment, Internet CBT led to superior PTSD outcomes vs. a waiting list. Post-treatment, videoconferencing had similar PTSD outcomes as face-to-face CBT. At follow-up, videoconferencing had inferior PTSD outcomes vs. face-to-face CBT. The quality of the evidence was moderate. Abstract: This systematic review and meta-analysis evaluated the efficacy of distance-delivered, guided approaches to treatment (e.g., delivered via telephone, Internet, mail, videoconferencing) for clinical and subclinical posttraumatic stress disorder (PTSD). A comprehensive search yielded 19 randomized controlled trials (1491 participants) to be included. Meta-analyses revealed that distance-delivered interventions led to significant within-group improvements in PTSD symptoms at post-treatment ( g = 0.81, 95% CI 0.65 to 0.97) and 3–6 month follow-up ( g = 0.78, 95% CI 0.59 to 0.97). Within-group depression and quality of life outcomes showed similar results, with medium post-treatment and follow-up effects. Compared to a waiting list, distance delivery (specifically, Internet treatments) led to superior PTSD outcomes ( g = 0.68, 95% CI 0.51 to 0.86). Compared to face-to-face interventions, distance delivery (specifically, videoconferencing treatments) did not result in significantly different PTSD outcomes at post-treatment ( g = −0.05, 95% CI −0.31 to 0.20) but led to inferior outcomes at 3–6 month follow-up ( g = −0.25, 95% CI −0.44 to −0.07). Distance delivery of PTSD treatment is promising, but research is needed to determine its optimal use.