Videoconferencing psychotherapy for veterans with PTSD: results from a randomized controlled non-inferiority trial
Abstract
INTRODUCTION: Veterans with post-traumatic stress disorder (PTSD) face significant barriers that make it less likely for them to pursue treatment. A randomized controlled non-inferiority trial was used to determine if providing psychotherapy for PTSD via videoconference (VC) is as effective as in-person (IP) psychotherapy. METHODS: = 207) received cognitive processing therapy (CPT) to treat PTSD symptoms in one of the two treatment modalities. Participant symptoms were collected at baseline, post-treatment, and six months after treatment completion. The primary outcome measure, the Clinician-Administered PTSD Scale (CAPS), was used to assess PTSD diagnosis and symptom severity. Secondary outcomes included two self-report measures of symptom severity, the Post-traumatic Stress Disorder Checklist - Specific (PCL-S) for PTSD and the Patient Health Questionnaire - 9 (PHQ-9) for depressive symptoms. A linear mixed-effects model was used to assess non-inferiority for participants who completed treatment (completers) and those who were randomized to treatment (intention-to-treat (ITT)). RESULTS: Both completer and ITT analyses showed that improvement in CAPS scores in the VC condition was non-inferior to that in the IP condition at six-month follow-up, but VC was inferior to IP for improvement in CAPS at post-treatment. Non-inferiority was supported by completer analyses for PCL-S and PHQ-9 in both post-treatment change and six-month follow-up change, and the ITT analysis supported the significant non-inferiority for PCL at post-treatment change. DISCUSSION: These findings generally suggest that CPT delivered via VC can be as effective as IP for reducing the severity of PTSD symptoms.
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The PTGI-SF has demonstrated good internal consistency in Chinese culture (Cronbach's α = 0.86).
“It has demonstrated good internal consistency in the Chinese culture (Cronbach's α = 0.86) (Liu et al., 2020).”
From Efficacy and mechanisms of mobile application-delivered Acceptance and Commitment Therapy for posttraumatic stress disorder in China: Study protocol for a randomized controlled trial (2022) · cites this paper as Liu et al., 2020
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].”
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- Authors
- Liu, L., Thorp, S. R., Moreno, L., Wells, S. Y., Glassman, L. H., Busch, A. C., Zamora, T., Rodgers, C. S., Allard, C. B., Morland, L. A., & Agha, Z.
- Affiliations
- University of California San Diego (US)
- Alliant University (US)
- VA San Diego Healthcare System (US)
- San Diego State University (US)
- Veterans Medical Research Foundation of San Diego (US)
- West Health (US)
- Corresponding author
- Liu, Lin
- Venue
- Journal of Telemedicine and Telecare
- Publisher
- SAGE Publications
- Published
- 2019-06-19
- Volume
- 26
- Issue
- 9
- Pages
- 507-519
- ISSN
- 1357-633X (ISSN-L)
- 1758-1109
- OpenAlex
- W2950673227
- Cited by
- 70
- References
- 35
- Citations by year
- 2026: 4 · 2025: 11 · 2024: 10 · 2023: 7 · 2022: 15 · 2021: 13 · 2020: 10
- FWCI
- 11.10
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Telemedicine and Telecare (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Veterans Affairs San Diego Healthcare System (DHI 07-054)
- 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, veterans, cognitive processing therapy, telemedicine, non-inferiority, PTSD symptom severity, depressive symptoms, barriers to treatment
- MeSH terms
- Equivalence Trials as Topic, Adult, Female, Humans, Male, Middle Aged, Psychotherapy, Severity of Illness Index, Socioeconomic Factors, Stress Disorders, Post-Traumatic, Veterans, Treatment Outcome, Videoconferencing
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