Internet-delivered cognitive behavioural therapy for post-traumatic stress disorder: Systematic review and meta-analysis
Abstract
OBJECTIVE: To determine whether Internet-delivered cognitive behavioural therapy (i-CBT) is an effective treatment for those who meet diagnostic criteria for post-traumatic stress disorder (PTSD). METHOD: A systematic review was undertaken according to Cochrane Collaboration Guidelines. The primary outcome measures were reduction in PTSD symptoms and drop-out. Categorical outcomes were meta-analysed as risk ratios (RRs) and continuous outcomes as mean differences (MDs) or standardised mean differences (SMDs). RESULTS: Ten studies with 720 participants were included. Evidence showed that i-CBT may be associated with a clinically important reduction in post-treatment PTSD symptoms compared with wait list (SMD -0.60, 95% confidence interval -0.97 to -0.24; N = 560); however, only three studies reported follow-up data, and there was no evidence to support the maintenance of symptom improvement at follow-up of 3-6 months. There was no evidence of a difference in PTSD symptoms between i-CBT and Internet-delivered non-CBT post-treatment. There was evidence of greater treatment effect from trauma-focused i-CBT than i-CBT without a trauma focus, as well as evidence that treatment effect was increased by the provision of guidance. CONCLUSIONS: While the review found some beneficial effects of i-CBT for PTSD post-treatment, the quality of the evidence was very low because of the small number of included trials and there was insufficient evidence to support the maintenance of improvement at follow-up of 3-6 months. Further work is required to establish non-inferiority to current first-line interventions; to determine long-term efficacy; to explore mechanisms of effect; and to establish optimal levels of guidance.
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TF-CBT delivered by therapists is effective in treating PTSD.
“Furthermore, there is substantial evidence supporting the efficacy of TF-CBT delivered by therapists in the treatment of PTSD [62].”
From Clinical Efficacy of Psychotherapeutic Interventions for Post-Traumatic Stress Disorder in Children and Adolescents: A Systematic Review and Analysis. (2024) · cites this paper as [62]
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- Authors
- Lewis, C., Roberts, N. P., Simon, N., Bethell, A., & Bisson, J. I.
- Affiliations
- Cardiff University (GB)
- Cardiff and Vale University Health Board (GB)
- University of Liverpool (GB)
- Corresponding author
- Lewis, C.
- Venue
- Acta Psychiatrica Scandinavica
- Publisher
- Wiley
- Published
- 2019-09-03
- Volume
- 140
- Issue
- 6
- Pages
- 508-521
- ISSN
- 0001-690X (ISSN-L)
- 1600-0447
- OpenAlex
- W2966204181
- Cited by
- 91
- References
- 50
- Citations by year
- 2026: 10 · 2025: 12 · 2024: 20 · 2023: 10 · 2022: 13 · 2021: 15 · 2020: 11
- FWCI
- 1.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Acta Psychiatrica Scandinavica (publishedVersion)
- PubMed (publishedVersion)
- ORCA Online Research @Cardiff (Cardiff University) (acceptedVersion)
- ORCA Online Research @Cardiff (Cardiff University) (submittedVersion)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- internet-based cognitive behavioral therapy, post-traumatic stress disorder, PTSD symptom reduction, treatment discontinuation, trauma-focused psychotherapy, therapist guidance
- MeSH terms
- Internet-Based Intervention, Humans, Stress Disorders, Post-Traumatic, Cognitive Behavioral Therapy
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