Internet-based guided self-help for posttraumatic stress disorder (PTSD): Randomized controlled trial
Open accessAbstract
BACKGROUND: There are numerous barriers that limit access to evidence-based treatment for posttraumatic stress disorder (PTSD). Internet-based guided self-help is a treatment option that may help widen access to effective intervention, but the approach has not been sufficiently explored for the treatment of PTSD. METHODS: Forty two adults with DSM-5 PTSD of mild to moderate severity were randomly allocated to internet-based self-help with up to 3 h of therapist assistance, or to a delayed treatment control group. The internet-based program included eight modules that focused on psychoeducation, grounding, relaxation, behavioural activation, real-life and imaginal exposure, cognitive therapy, and relapse prevention. The primary outcome measure was reduction in clinician-rated traumatic stress symptoms using the clinician administered PTSD scale for DSM-V (CAPS-5). Secondary outcomes were self-reported PTSD symptoms, depression, anxiety, alcohol use, perceived social support, and functional impairment. RESULTS: Posttreatment, the internet-based guided self-help group had significantly lower clinician assessed PTSD symptoms than the delayed treatment control group (between-group effect size Cohen's d = 1.86). The difference was maintained at 1-month follow-up and dissipated once both groups had received treatment. Similar patterns of difference between the two groups were found for depression, anxiety, and functional impairment. The average contact with treating clinicians was 2½ h. CONCLUSIONS: Internet-based trauma-focused guided self-help for PTSD is a promising treatment option that requires far less therapist time than current first line face-to-face psychological therapy.
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Data on the efficacy of internet-delivered cognitive-behavioral therapy are available for a wide range of psychological disorders, including stress-related disorders.
“Currently, data on the efficacy of ICBT are available for a wide range of psychological disorders, including stress-related disorders [19–23].”
From An internet-based intervention for adjustment disorder (TAO): Study protocol for a randomized controlled trial (2018) · cites this paper as [21]
The Discussion (section 4, page unavailable) reports that internet-based guided self-help reduced PTSD symptoms compared with delayed treatment, supporting the stress-related-disorder example. This trial concerns PTSD of mild to moderate severity; it does not itself establish efficacy across a wide range of psychological disorders. (LLM, conf=0.84)
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The reconsolidation using rewind study (RETURN): trial protocol
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Translation to the clinic and other modalities
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- Authors
- Lewis, C. E., Farewell, D., Groves, V., Kitchiner, N. J., Roberts, N. P., Vick, T., & Bisson, J. I.
- Affiliations
- Cardiff University (GB)
- Cardiff and Vale University Health Board (GB)
- Corresponding author
- Lewis, Catrin E.
- Venue
- Depression and Anxiety
- Publisher
- Wiley
- Published
- 2017-05-29
- Volume
- 34
- Issue
- 6
- Pages
- 555-565
- ISSN
- 1091-4269 (ISSN-L)
- OpenAlex
- W2617965641
- Cited by
- 84
- References
- 51
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 8 · 2023: 15 · 2022: 10 · 2021: 16 · 2020: 10 · 2019: 8 · 2018: 6 · 2017: 1
- FWCI
- 8.46
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- ORCA Online Research @Cardiff (Cardiff University) (acceptedVersion)
- Funders
- Technology Strategy Board (KTP008512)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- post-traumatic stress disorder, online therapy, imaginal exposure, behavioral activation, grounding, relapse prevention, access to mental health care, depression, anxiety, functional disability, social support, alcohol consumption
- MeSH terms
- Self-Management, Adult, Aged, Female, Humans, Male, Middle Aged, Psychotherapy, Stress Disorders, Post-Traumatic, Internet, Young Adult
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