Efficacy of a Therapist-Assisted Self-Help Internet-Based Intervention Targeting PTSD, Depression, and Insomnia Symptoms After a Disaster: A Randomized Controlled Trial. Issue 2 (March 2023)

• Record Type: Journal Article
• Authors: Belleville, Geneviève; Ouellet, Marie-Christine; Békés, Vera; Lebel, Jessica; Morin, Charles M.; Bouchard, Stéphane; Guay, Stéphane; Bergeron, Nicolas; Ghosh, Sunita; Campbell, Tavis; Macmaster, Frank P.
• Is Part Of: Behavior therapy. Volume 54:Issue 2(2023)
• Page Start: 230
• Page End: 246
• Publication Date: 2023-03
• Subjects: natural disaster -- PTSD -- depression -- insomnia -- e-mental health; Behavior therapy -- Periodicals; 616.8914205
• DOI: 10.1016/j.beth.2022.08.004
• Languages: English
• ISSNs: 0005-7894

Abstract

Highlights: RESILIENT is an online CBT developed for individuals exposed to a natural disaster. RESILIENT reduced posttraumatic stress, depression, insomnia, and anxiety symptoms. RESILIENT may be helpful to individuals with mild or moderate mental health issues. RESILIENT could improve access to evidence-based mental health care after a disaster. Abstract: This study aimed at evaluating the efficacy of an online CBT intervention with limited therapist contact targeting a range of posttraumatic symptoms among evacuees from the 2016 Fort McMurray wildfires. One hundred and thirty-six residents of Fort McMurray who reported either moderate PTSD symptoms (PCL-5 ≥ 23) or mild PTSD symptoms (PCL-5 ≥ 10) with moderate depression (PHQ-9 ≥ 10) or subthreshold insomnia symptoms (ISI ≥ 8) were randomized either to a treatment ( n = 69) or a waitlist condition ( n = 67). Participants were on average 45 years old, and mostly identified as White (82%) and as women (76%). Primary outcomes were PTSD, depression, and insomnia symptoms. Secondary outcomes were anxiety symptoms and disability. Significant Assessment Time × Treatment Condition interactions were observed on all outcomes, indicating that access to the treatment led to a decrease in posttraumatic stress (F[1, 117.04] = 12.128, p = .001; d = .519, 95% CI = .142–.895), depression (F[1, 118.29] = 9.978, p = .002; d = .519, 95% CI = .141–.898) insomnia (F[1, 117.60] = 4.574, p = .035; d = .512, 95% CI = .132–.892), and anxiety (F[1, 119.64] = 5.465, p = .021; d = .421, 95% CI = .044–.797) symptom severity and disability (F[1, 111.55] = 7.015, p = .009; d = .582, 95% CI = .200–.963). Larger effect sizes ( d = 0.823–1.075) were observed in participants who completed at least half of the treatment. The RESILIENT online treatment platform was successful to provide access to specialized evidence-based mental health care after a disaster.