Cited by 235Posttraumatic Stress Disorder ResearchTelemedicine and Telehealth ImplementationPsychotherapy Techniques and Applications

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Cognitive Processing Therapy for Posttraumatic Stress Disorder Delivered to Rural Veterans via Telemental Health: A Randomized Noninferiority Clinical Trial

Morland, Leslie A., Mackintosh, Margaret-Anne, Greene, Carolyn J., Rosen, Craig S., Chard, Kathleen M., Resick, Patricia, Frueh, B. Christopher·2014·The Journal of Clinical Psychiatry

DOI 10.4088/jcp.13m08842

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Abstract

OBJECTIVE: To compare clinical and process outcomes of cognitive processing therapy-cognitive only version (CPT-C) delivered via videoteleconferencing (VTC) to in-person in a rural, ethnically diverse sample of veterans with posttraumatic stress disorder (PTSD). METHOD: A randomized clinical trial with a noninferiority design was used to determine if providing CPT-C via VTC is effective and "as good as" in-person delivery. The study took place between March 2009 and June 2013. PTSD was diagnosed per DSM-IV. Participants received 12 sessions of CPT-C via VTC (n = 61) or in-person (n = 64). Assessments were administered at baseline, midtreatment, immediately posttreatment, and 3 and 6 months posttreatment. The primary clinical outcome was posttreatment PTSD severity, as measured by the Clinician-Administered PTSD Scale. RESULTS: Clinical and process outcomes found VTC to be noninferior to in-person treatment. Significant reductions in PTSD symptoms were identified at posttreatment (Cohen d = 0.78, P < .05) and maintained at 3- and 6-month follow-up (d = 0.73, P < .05 and d = 0.76, P < .05, respectively). High levels of therapeutic alliance, treatment compliance, and satisfaction and moderate levels of treatment expectancies were reported, with no differences between groups (for all comparisons, F < 1.9, P > .17). CONCLUSIONS: Providing CPT-C to rural residents with PTSD via VTC produced outcomes that were "as good as" in-person treatment. All participants demonstrated significant reductions in PTSD symptoms posttreatment and at follow-up. Results indicate that VTC can offer increased access to specialty mental health care for residents of rural or remote areas. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT00879255.

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“This result is consistent with other findings that the therapeutic alliance developed within a therapy group is just as strong over telehealth as it is in person (Lopez et al., 2020; Morland et al., 2014; Preschl et al., 2011).”
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“…symptoms related to a variety of trauma aetiologies such as child physical and sexual abuse, combat trauma and rape (Bass et al., 2013; Chard, 2005; Forbes et al., 2012; Maieritsch et al., 2016; Monson et al., 2006; Morland et al., 2014; Resick and Schnicke, 1992; Resick et al., 2002, 2008, 2015).”
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Authors: Morland, L. A., Mackintosh, M.-A., Greene, C. J., Rosen, C. S., Chard, K. M., Resick, P., & Frueh, B. C.
Affiliations: National Center for PTSD (US)
VA Palo Alto Health Care System (US)
Cincinnati VA Medical Center (US)
VA Boston Healthcare System (US)
University of Hawaii at Hilo (US)
ORCID: Morland, Leslie A.
Mackintosh, Margaret-Anne
Greene, Carolyn J.
Rosen, Craig S.
Chard, Kathleen M.
Resick, Patricia
Frueh, B. Christopher
Venue: The Journal of Clinical Psychiatry
Publisher: Physicians Postgraduate Press, Inc
Published: 2014-05-15
Volume: 75
Issue: 05
Pages: 470-476
ISSN: 0160-6689 (ISSN-L)
DOI: 10.4088/jcp.13m08842
OpenAlex: W2088885347
Cited by: 234
References: 0
Citations by year: 2026: 6 · 2025: 16 · 2024: 12 · 2023: 13 · 2022: 36 · 2021: 23 · 2020: 22 · 2019: 25 · 2018: 21 · 2017: 20 · 2016: 17 · 2015: 22 · 2014: 1
FWCI: 23.60
Type: journal article
Language: en
Open access: closed
Locations: The Journal of Clinical Psychiatry (publishedVersion)
PubMed (publishedVersion)
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: cognitive processing therapy, post-traumatic stress disorder, veterans, rural mental health services, telemental health, non-inferiority, access to specialist care, therapeutic relationship, medication adherence, treatment satisfaction, treatment expectancy
MeSH terms: Adult, Humans, Male, Middle Aged, Prospective Studies, Psychotherapy, Group, Rural Population, Severity of Illness Index, Stress Disorders, Post-Traumatic, United States, Veterans, Cognitive Behavioral Therapy, Treatment Outcome, Telemedicine

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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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