TELEMEDICINE VERSUS IN-PERSON DELIVERY OF COGNITIVE PROCESSING THERAPY FOR WOMEN WITH POSTTRAUMATIC STRESS DISORDER: A RANDOMIZED NONINFERIORITY TRIAL: Research Article: Telemental Health for Women with PTSD

Morland, Leslie A.; Mackintosh, Margaret-Anne; Rosen, Craig S.; Willis, Emy; Resick, Patricia; Chard, Kathleen; Frueh, B. Christopher

doi:10.1002/da.22397

Cited by 177Posttraumatic Stress Disorder ResearchTelemedicine and Telehealth ImplementationPsychotherapy Techniques and Applications

TELEMEDICINE VERSUS IN-PERSON DELIVERY OF COGNITIVE PROCESSING THERAPY FOR WOMEN WITH POSTTRAUMATIC STRESS DISORDER: A RANDOMIZED NONINFERIORITY TRIAL: Research Article: Telemental Health for Women with PTSD

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Morland, Leslie A., Mackintosh, Margaret-Anne, Rosen, Craig S., Willis, Emy, Resick, Patricia, Chard, Kathleen, Frueh, B. Christopher·2015·Depression and Anxiety

DOI 10.1002/da.22397

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Abstract

BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

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No large controlled trial of psychotherapy delivered by videoconference has involved generalized anxiety disorder (GAD).
“Delivering psychotherapy by videoconference has been studied in a number of clinical trials, but no large controlled trial has involved generalized anxiety disorder (GAD).”
From A Multisite Non-Inferiority Randomized Controlled Trial of the Efficacy of Cognitive-Behavior Therapy for Generalized Anxiety Disorder Delivered by Videoconference (2022) · cites this paper as [38]
The Introduction says videoconference psychotherapy has been studied across various patient populations, and the paper reports a controlled trial involving women with PTSD. Neither the Introduction nor the passages retrieved for GAD and large controlled trials establish that no such trial has involved GAD. (LLM, conf=0.82)
Experimental — accuracy not yet measured
A handful of studies have documented the non-inferiority of VCP when compared to gold-standard treatments.
“Moreover, a handful of studies have documented the non-inferiority of VCP when compared to gold-standard treatments [34,35,36,37,38].”
From A Multisite Non-Inferiority Randomized Controlled Trial of the Efficacy of Cognitive-Behavior Therapy for Generalized Anxiety Disorder Delivered by Videoconference (2022) · cites this paper as [38]
Studies have shown similar efficacy between in-person and telehealth interventions.
“studies have shown similar efficacy between IP and telehealth interventions.”
From Telehealth Versus In-Person Acceptance and Commitment Therapy for Chronic Pain: A Randomized Noninferiority Trial. (2017) · cites this paper as [40]

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Depression and Anxiety 15206394, 2015, 11, · DOI
Greene CJ, Morland LA, Macdonald A, et al. How does use of telemental health affect the group therapy process? Results from a randomized clinical noninferiority trial. J Consult Clin Psychol 2010;78:746-750.
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Depression and Anxiety 15206394, 2015, 11, · DOI

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Trauma-focused treatment for comorbid post-traumatic stress and substance use disorder
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Effect of cognitive processing therapy on markers of cardiovascular risk in posttraumatic stress disorder patients: A randomized clinical trial
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The Impact of Military Status on Cognitive Processing Therapy Outcomes in the Community
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A Multisite Non-Inferiority Randomized Controlled Trial of the Efficacy of Cognitive-Behavior Therapy for Generalized Anxiety Disorder Delivered by Videoconference
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Study adaptation, design, and methods of a web-based PTSD intervention for women Veterans
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Psychotherapy and depressive symptom trajectories among VA patients: Comparing dose-effect and good-enough level models.
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Using EMDR Therapy to Treat Clients Remotely
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Feasibility, satisfaction, acceptability and safety of telehealth for First Nations and culturally and linguistically diverse people: a scoping review
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Design of a clinical effectiveness trial of in-home cognitive processing therapy for combat-related PTSD
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Teaching the Fundamentals of Remote Psychotherapy to Psychiatry Residents in the COVID-19 Pandemic
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Clinician Concerns About Cognitive Processing Therapy: A Review of the Evidence
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Correcting Misperceptions About Cognitive Processing Therapy to Treat Moral Injury: A Response to Gray and Colleagues (this issue)
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Quality of life following treatment for PTSD: Comparison of videoconferencing and in-person modalities
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Psychological Interventions for Survivors of Intimate Partner Violence in Humanitarian Settings: An Overview of the Evidence and Implementation Considerations
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Testing a variable-length Cognitive Processing Therapy intervention for posttraumatic stress disorder in active duty military: Design and methodology of a clinical trial
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Conducting Prolonged Exposure for PTSD During the COVID-19 Pandemic: Considerations for Treatment
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Gender differences in response to acceptance and commitment therapy among operation enduring Freedom/Operation iraqi Freedom/Operation new Dawn veterans
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Implementing Behavioral Couples Therapy for Substance Use Disorders in Real‐World Clinical Practice
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Telehealth in Psychiatric Nursing Education: Lessons From the Field
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Examining Changes in Sexual Functioning after Cognitive Processing Therapy in a Sample of Women Trauma Survivors
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Telehealth in Response to the COVID‐19 Pandemic in Rural Veteran and Military Beneficiaries
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Impacts of Internet-Based Interventions for Veterans With PTSD: A Systematic Review and Meta-Analysis
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Delivering evidence-based practices via telepsychology: Illustrative case series from military treatment facilities.
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Barriers and Facilitators to Behavioral Healthcare for Women Veterans: a Mixed-Methods Analysis of the Current Landscape
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Predictors of Quality of Life Following Cognitive Processing Therapy Among Women and Men With Post-Traumatic Stress Disorder
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Comparing written exposure therapy to Prolonged Exposure for the treatment of PTSD in a veteran sample: A non-inferiority randomized design
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Study design comparing written exposure therapy to cognitive processing therapy for PTSD among military service members: A noninferiority trial
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Evidence‐Based Practice for Posttraumatic Stress Disorder
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Deploying a telemedicine collaborative care intervention for posttraumatic stress disorder in the U.S. Department of Veterans Affairs: A stepped wedge evaluation of an adaptive implementation strategy
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An explanatory sequential investigation of the working alliance as a change process in videoconferencing psychotherapy
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Uses of Virtual Care in Primary Care: Scoping Review
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Using Sensor-Captured Patient-Generated Data to Support Clinical Decision-making in PTSD Therapy
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Tailoring Cognitive Behavioral Therapy for Trauma-Exposed Persons Living With HIV
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Treating Posttraumatic Stress Disorder in the Presence of Acute Suicide Risk in Veterans and Active Duty Service Members
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Open trial of an adaptation of cognitive processing therapy for message-based delivery.
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Understanding the Mental Health Needs of a Community-Sample of UK Women Veterans
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Massed cognitive processing therapy for combat-related posttraumatic stress disorder: Study design and methodology of a non-inferiority randomized controlled trial
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A meta-analytic review of cognitive processing therapy with and without the written account
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The effect of reducing posttraumatic stress disorder symptoms on cardiovascular risk: Design and methodology of a randomized clinical trial
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Cognitive Processing Therapy for Posttraumatic Stress Disorder Delivered to Rural Veterans via Telemental Health: A Randomized Noninferiority Clinical Trial
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Group cognitive processing therapy delivered to veterans via telehealth: A pilot cohort
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Videoconferencing psychotherapy for veterans with PTSD: results from a randomized controlled non-inferiority trial
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Randomized controlled equivalence trial comparing videoconference and in person delivery of cognitive processing therapy for PTSD
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Morland, L. A., Greene, C. J., Rosen, C. S., Foy, D., Reilly, P., Shore, J., He, Q., & Frueh, C. (2010) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.09m05604blu · Cited by 274 · see citing works
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Authors: Morland, L. A., Mackintosh, M.-A., Rosen, C. S., Willis, E., Resick, P., Chard, K., & Frueh, B. C.
Affiliations: National Center for PTSD (US)
VA Palo Alto Health Care System (US)
Duke Medical Center (US)
Cincinnati VA Medical Center (US)
University of Hawaii System (US)
Corresponding author: Morland, Leslie A.
ORCID: Morland, Leslie A.
Mackintosh, Margaret-Anne
Rosen, Craig S.
Resick, Patricia
Chard, Kathleen
Frueh, B. Christopher
Venue: Depression and Anxiety
Publisher: Hindawi Limited
Published: 2015-08-03
Volume: 32
Issue: 11
Pages: 811-820
ISSN: 1091-4269 (ISSN-L)
DOI: 10.1002/da.22397
OpenAlex: W2130606351
Cited by: 176
References: 39
Citations by year: 2026: 8 · 2025: 10 · 2024: 12 · 2023: 16 · 2022: 34 · 2021: 27 · 2020: 21 · 2019: 14 · 2018: 14 · 2017: 10 · 2016: 10
FWCI: 14.05
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: doi.wiley.com/10.1002/tdm_license_1.1 (tdm, 29 d)
Locations: Depression and Anxiety (publishedVersion)
PubMed (publishedVersion)
Funders: Department of Defense, Congressionally Directed Medical Research Programs (PTO90552, W81XWH-10-1-1037)
Topics: Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords: post-traumatic stress disorder, cognitive processing therapy, telemedicine, women, veterans, access to mental health care, non-inferiority, rural and remote areas
MeSH terms: Adult, Female, Humans, Middle Aged, Stress Disorders, Post-Traumatic, Telecommunications, Cognitive Behavioral Therapy, Treatment Outcome, Telemedicine

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TELEMEDICINE VERSUS IN-PERSON DELIVERY OF COGNITIVE PROCESSING THERAPY FOR WOMEN WITH POSTTRAUMATIC STRESS DISORDER: A RANDOMIZED NONINFERIORITY TRIAL: Research Article: Telemental Health for Women with PTSD

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