A randomized, controlled proof-of-concept trial of an Internet-based, therapist-assisted self-management treatment for posttraumatic stress disorder

Am J Psychiatry. 2007 Nov;164(11):1676-83. doi: 10.1176/appi.ajp.2007.06122057.


Objective: The authors report an 8-week randomized, controlled proof-of-concept trial of a new therapist-assisted, Internet-based, self-management cognitive behavior therapy versus Internet-based supportive counseling for posttraumatic stress disorder (PTSD).

Method: Service members with PTSD from the attack on the Pentagon on September 11th or the Iraq War were randomly assigned to self-management cognitive behavior therapy (N=24) or supportive counseling (N=21).

Results: The dropout rate was similar to regular cognitive behavior therapy (30%) and unrelated to treatment arm. In the intent-to-treat group, self-management cognitive behavior therapy led to sharper declines in daily log-on ratings of PTSD symptoms and global depression. In the completer group, self-management cognitive behavior therapy led to greater reductions in PTSD, depression, and anxiety scores at 6 months. One-third of those who completed self-management cognitive behavior therapy achieved high-end state functioning at 6 months.

Conclusions: Self-management cognitive behavior therapy may be a way of delivering effective treatment to large numbers with unmet needs and barriers to care.

Publication types

  • Comparative Study
  • Evaluation Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Cognitive Behavioral Therapy / methods*
  • Cognitive Behavioral Therapy / standards
  • Combat Disorders / diagnosis
  • Combat Disorders / psychology
  • Combat Disorders / therapy
  • Counseling / methods*
  • Counseling / standards
  • Follow-Up Studies
  • Humans
  • Internet*
  • Iraq
  • Male
  • Military Personnel / psychology
  • Personality Inventory
  • Program Evaluation
  • Psychiatric Status Rating Scales
  • Psychotherapy, Group
  • Self Care / methods*
  • Self Care / standards
  • September 11 Terrorist Attacks / psychology
  • Social Support
  • Stress Disorders, Post-Traumatic / diagnosis
  • Stress Disorders, Post-Traumatic / psychology
  • Stress Disorders, Post-Traumatic / therapy*
  • Surveys and Questionnaires
  • Treatment Outcome
  • Warfare