Internet-based trauma-focused cognitive behavioural therapy for PTSD with and without exposure components: a randomised controlled trial

Abstract

Background: Internet-delivered trauma-focused cognitive behavioural therapy is efficacious for PTSD; however, no studies have investigated the roles of individual treatment components or the safety of online treatments.

Aims: To compare the efficacy and safety of an online treatment for PTSD comprised of psychoeducation, stress management, cognitive restructuring and exposure components with the equivalent protocol without the exposure components, using a randomised controlled trial design.

Methods: Sixty-six individuals were randomised to a non-exposure condition and 59 to the full protocol with exposure components. Treatment duration was 8 weeks and pre-, post-treatment and three-month follow-up outcomes were analysed using a mixed linear modelling approach.

Results: Both groups achieved improvements in symptoms with no differences between groups on any primary or secondary outcome measures, diagnostic remission rates or adverse events.

Limitations: The study included several secondary measures that have not been previously validated and treatments were not time matched in terms of number of lessons.

Conclusions: These findings indicate that trauma-focused cognitive behavioural therapy for PTSD with or without exposure components can be safe and efficacious.

Keywords: Cognitive behavioural therapy; Internet; PTSD; Posttraumatic stress disorder; Randomized controlled trial; Trauma.