The acceptability of a guided internet-based trauma-focused self-help programme (Spring) for post-traumatic stress disorder (PTSD)

Background: Guided internet-based, cognitive behavioural therapy with a trauma-focus (i-CBT-TF) is recommended in guidelines for post-traumatic stress disorder (PTSD). There is limited evidence regarding its acceptability, with significant dropout from individual face-to-face CBT-TF, suggesting non-acceptability at least in some cases.

 

Objective: To determine the acceptability of a guided internet-based CBT-TF intervention, ‘Spring’, in comparison with face-to-face CBT-TF for mild to moderate PTSD.

 

Method: Treatment adherence, satisfaction, and therapeutic alliance were measured quantitatively for participants receiving ‘Spring’ or face-to-face CBT-TF as part of a Randomised Controlled Trial. Qualitative interviews were conducted with a purposive sample of therapists and participants.

 

Results: ‘Spring’ guided internet-based CBT-TF was found to be acceptable, with over 89% participants fully or partially completing the programme. Therapy adherence and alliance for ‘Spring’ and face-to-face CBT-TF did not differ significantly, apart from post-treatment participant-reported alliance, which was in favour of face-to-face CBT-TF. Treatment satisfaction was high for both treatments, in favour of face-to-face CBT-TF. Interviews with participants receiving, and therapists delivering ‘Spring’ corroborated its acceptability.

 

Conclusions: Guided internet-based CBT-TF is acceptable for many people with mild to moderate PTSD. Findings provide insights into future implementation, highlighting the importance of personalising guided self-help, depending on an individual’s presentation, and preferences.

 

HIGHLIGHTS

  • Guided internet-based trauma-focused CBT is an acceptable treatment for PTSD.
  • A model of acceptability explained 45% of variance in treatment outcome.
  • Importance of adapting guided self-help to suit presentation and preferences.
Reference: 
Natalie Simon, Catrin E. Lewis, Kim Smallman, Lucy Brookes-Howell, Neil P. Roberts, Neil J. Kitchiner, Cono Ariti, Claire Nollett, Rachel McNamara & Jonathan I. Bisson | 2023
In: European Journal of Psychotraumatology ; ISSN: 2000-8066 | 14 | 2 | juni | 2212554
https://doi.org/10.1080/20008066.2023.2212554
Keywords: 
Effectiveness, Instruments, Internet Therapy, Interventions, Personal Interview, Posttraumatic Stress Disorder, Psychotrauma, PTSD (DSM-5), PTSD (en), Systematic Review, Telemedicine, Trauma Focused Cognitive Behavioral Therapy, Treatment, Treatment Dropouts