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- Title
TELEMEDICINE VERSUS IN-PERSON DELIVERY OF COGNITIVE PROCESSING THERAPY FOR WOMEN WITH POSTTRAUMATIC STRESS DISORDER: A RANDOMIZED NONINFERIORITY TRIAL.
- Authors
Morland, Leslie A.; Mackintosh, Margaret‐Anne; Rosen, Craig S.; Willis, Emy; Resick, Patricia; Chard, Kathleen; Frueh, B. Christopher
- Abstract
<bold>Background: </bold>This study examined the effectiveness of telemedicine to provide psychotherapy to women with posttraumatic stress disorder (PTSD) who might be unable to access treatment. Objectives were to compare clinical and process outcomes of PTSD treatment delivered via videoteleconferencing (VTC) and in-person (NP) in an ethnically diverse sample of veteran and civilian women with PTSD.<bold>Methods: </bold>A randomized controlled trial of Cognitive Processing Therapy, an evidence-based intervention for PTSD, was conducted through a noninferiority design to compare delivery modalities on difference in posttreatment PTSD symptoms. Women with PTSD, including 21 veterans and 105 civilians, were assigned to receive psychotherapy delivered via VTC or NP. Primary treatment outcomes were changes in PTSD symptoms in the completer sample.<bold>Results: </bold>Improvements in PTSD symptoms in the VTC condition (n = 63) were noninferior to outcomes in the NP condition (n = 63). Clinical outcomes obtained when both conditions were pooled together (N = 126) demonstrated that PTSD symptoms declined substantially posttreatment (mean = -20.5, 95% CI -29.6 to -11.4) and gains were maintained at 3- (mean = -20.8, 95% CI -30.1 to -11.5) and 6-month followup (mean = -22.0, 95% CI -33.1 to -10.9. Veterans demonstrated smaller symptom reductions posttreatment (mean = -9.4, 95% CI -22.5 to 3.7) than civilian women (mean = -22.7, 95% CI -29.9 to -15.5.<bold>Conclusions: </bold>Providing psychotherapy to women with PTSD via VTC produced outcomes comparable to NP treatment. VTC can increase access to specialty mental health care for women in rural or remote areas.
- Subjects
TELEMEDICINE; COGNITIVE therapy; POST-traumatic stress disorder; CLINICAL trials; WOMEN'S mental health; EVIDENCE-based psychotherapy; FOLLOW-up studies (Medicine); TREATMENT of post-traumatic stress disorder; COMPARATIVE studies; RESEARCH methodology; MEDICAL cooperation; RESEARCH; TELECOMMUNICATION; EVALUATION research; RANDOMIZED controlled trials; TREATMENT effectiveness
- Publication
Depression & Anxiety (1091-4269), 2015, Vol 32, Issue 11, p811
- ISSN
1091-4269
- Publication type
journal article
- DOI
10.1002/da.22397