The DOI matches its Crossref record.
Cognitive Processing Therapy for Posttraumatic Stress Disorder Delivered to Rural Veterans via Telemental Health: A Randomized Noninferiority Clinical Trial
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.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Moreover, a handful of studies have documented the non-inferiority of VCP when compared to gold-standard treatments [34,35,36,37,38].”
Citations
Cited by
Sorted by citations
Items 201–235 of 235
Hungerbuehler, I. (2015) · Digital Library of Theses and Dissertations (Universidade de São Paulo) · doi:10.11606/t.5.2015.tde-26102015-153921 · Cited by 1
Walker, D. D., Walton, T. O., Jaffe, A. E., Graupensperger, S. A., Rhew, I. C., & Kaysen, D. L. (2022) · SSRN Electronic Journal · doi:10.2139/ssrn.4136965 · Cited by 1
VISN 22 Evidenced-Based Psychotherapy Telemental Health Center and Regional Pilot.
Williams, K., Kern, S. M., Thorp, S. R., Paulus, M. P., Shah, N., Morland, L. A., & Hauser, P. (2015) · Europe PMC (PubMed Central)
Self-citationRenno, S. (2019) · Scholarly Commons (University of Pennsylvania)
Hybrid Practitioners and Digital Treatments
Yellowlees, P., & Shore, J. H. (2019) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615371501.lr36
Yelin, E. H., Trupin, L. S., Fangs, M.-L., Melnikow, J. A., Weyrich, M. S., Roby, D. H., Cosway, R. G., Pantely, S., Marcin, J. P., Marcus, J., et al. (2015) · eScholarship (California Digital Library)
Treatment development: The early years
Galovski, T. E., Nixon, R. D. V., & Kaysen, D. L. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-816715-1.00003-0
Program Evaluation of Telemental Health Services
Schwarting, J. (2019) · UA Campus Repository (The University of Arizona)
Pagel, J. F. (2020) · Springer eBooks · doi:10.1007/978-3-030-55909-0_9
Moring, J. C., Resick, P. A., Peterson, A. L., et al. (2020) · doi:10.21203/rs.3.rs-95013/v1
Self-citationChapter 36. Hybrid Practitioners and Digital Treatments
Yellowlees, P., & Shore, J. H. (2019) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615372980.lr36
Novel Approaches for Treating Anxiety Disorders
Sturman, D. A., Kaufman, M. L., Bigony, C. E., & Ressler, K. J. (2017) · Oxford University Press eBooks · doi:10.1093/med/9780190681425.003.0039
Telemental Health Approaches for Trauma Survivors
Kuhn, E. R., Hoffman, J. E., Ruzek, J. I., & Owen, J. E. (2022) · Springer eBooks · doi:10.1007/978-3-030-97802-0_26
de Castro, T. G., Guerin, K. S. D. A., & Pimentel, L. I. R. (2022) · Contextos Clínicos · doi:10.4013/ctc.2022.152.13
“A psicoterapia on-line é apontada como uma alternativa para o atendimento de pessoas que não têm acesso aos serviços de saúde ou que vivem em regiões isoladas (Morland et al., 2014; Nóbrega, 2015).”
BackgroundClinical Health Psychologists’ Role in the COVID-19 Response in Veteran and Military Hospitals
Pritchard, K. J., & James, L. C. (2022) · Springer eBooks · doi:10.1007/978-3-031-12063-3_11
The Future of Medicine/Healthcare in the Metaverse
Kumagai, H. (2025) · IEEJ Transactions on Electronics Information and Systems · doi:10.1541/ieejeiss.145.417
Delivering CPT Using Telehealth
Morland, L. A., Glassman, L. H., Wachsman, T. R., & Moring, J. C. (2025) · CBT: science into practice · doi:10.1007/978-3-031-87356-0_16
Self-citationGroup Cognitive Processing Therapy
Scheid, C. R., Martin, C. E., & Chard, K. M. (2025) · CBT: science into practice · doi:10.1007/978-3-031-87356-0_13
Self-citationPTSD, cannabis use, and expected symptom relief: gender-moderated mediational effects
Ueno, L. F. (2023) · Scholars Archive - University at Albany (University at Albany, State University of New York) · doi:10.54014/n5dz-yakb
Kara, Y., & Er, F. (2025) · Child & Family Behavior Therapy · doi:10.1080/07317107.2025.2529374
“Several studies in the literature show that veterans and their spouses benefit from group therapy, especially those incorporating Cognitive-Behavioral Therapy (CBT) techniques (Fredman et al., 2020; Kuyken et al., 2015; Macdonald et al., 2022; Morland et al., 2014).”
Palli, A. (2025) · European Family Therapy Association series · doi:10.1007/978-3-031-92225-1_13
Kras, K. R., Butterfield, P., Byrne, J. M., Rapisarda, S. S., Hummer, D., & Socia, K. M. (2025) · Health & Justice · doi:10.1186/s40352-025-00386-w
“…for either mental health or substance abuse treatment (Tauscher et al., 2023; Wells et al., 2024), and a series of VA-based studies showing support for the effectiveness of telehealth interventions (Godleski et al., 2012; McGeary et al., 2023; Morland et al., 2014, 2015; Peterson et al., 2022).”
Peterson, A. L., Mintz, J., Moring, J. C., Straud, C. L., Young‐McCaughan, S., McGeary, C. A., McGeary, D. D., Litz, B. T., Velligan, D. I., Macdonald, A., et al. (2022) · Figshare · doi:10.6084/m9.figshare.18585829
Self-citationPeterson, A. L., Mintz, J., Moring, J. C., Straud, C. L., Young‐McCaughan, S., McGeary, C. A., McGeary, D. D., Litz, B. T., Velligan, D. I., Macdonald, A., et al. (2022) · Figshare · doi:10.6084/m9.figshare.18585826
Self-citationPeterson, A. L., Mintz, J., Moring, J. C., Straud, C. L., Young‐McCaughan, S., McGeary, C. A., McGeary, D. D., Litz, B. T., Velligan, D. I., Macdonald, A., et al. (2022) · Figshare · doi:10.6084/m9.figshare.18585835
Self-citationPeterson, A. L., Mintz, J., Moring, J. C., Straud, C. L., Young‐McCaughan, S., McGeary, C. A., McGeary, D. D., Litz, B. T., Velligan, D. I., Macdonald, A., et al. (2022) · Figshare · doi:10.6084/m9.figshare.18585844
Self-citationPeterson, A. L., Mintz, J., Moring, J. C., Straud, C. L., Young‐McCaughan, S., McGeary, C. A., McGeary, D. D., Litz, B. T., Velligan, D. I., Macdonald, A., et al. (2022) · Figshare · doi:10.6084/m9.figshare.18585823
Self-citationPeterson, A. L., Mintz, J., Moring, J. C., Straud, C. L., Young‐McCaughan, S., McGeary, C. A., McGeary, D. D., Litz, B. T., Velligan, D. I., Macdonald, A., et al. (2022) · Figshare · doi:10.6084/m9.figshare.18585841
Self-citationPeterson, A. L., Mintz, J., Moring, J. C., Straud, C. L., Young‐McCaughan, S., McGeary, C. A., McGeary, D. D., Litz, B. T., Velligan, D. I., Macdonald, A., et al. (2022) · Figshare · doi:10.6084/m9.figshare.18585832
Self-citationPeterson, A. L., Mintz, J., Moring, J. C., Straud, C. L., Young‐McCaughan, S., McGeary, C. A., McGeary, D. D., Litz, B. T., Velligan, D. I., Macdonald, A., et al. (2022) · Figshare · doi:10.6084/m9.figshare.18585838
Self-citationAn Investigation of a Community-Based Phase-I Online Group Trauma Intervention
Harmsen, C. R. W., Langdon, G. A., Cribbie, R. A., Baranowsky, A., & Muller, R. T. (2026) · International Journal of Group Psychotherapy · doi:10.1080/00207284.2025.2600104
“…has been effective with diverse groups, such as grieving mothers and individuals in conflict regions (Kersting et al., 2011; Knaevelsrud et al., 2015), first responders (Farrell et al., 2023), ovarian cancer survivors (Kinner et al., 2018), and veterans (Liu et al., 2020; Morland et al., 2014).”
Warner, G., Löfving, S. G., & Geijer‐Simpson, E. (2026) · Internet Interventions · doi:10.1016/j.invent.2026.100918
“These results were supported in a larger RCT (Morland et al., 2014).”
Piccardo, M. A., Bernuzzi, C., & Guglielmetti, C. (2026) · Humanities and Social Sciences Communications · doi:10.1057/s41599-026-06729-8
“The fi rst peak was in 2014, with the study of Morland et al. (2014) about the use of telepsychology for rural veterans with PTSD.”
Cognitive Therapy Approaches for Posttraumatic Stress Disorder (PTSD) in Adults
Littleton, H., Zamundu, A., Higgins, M., & Mohamed, N. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-29009-1.00073-1
Metadata
- 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
- 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)
- 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
