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TELEMEDICINE VERSUS IN‐PERSON DELIVERY OF COGNITIVE PROCESSING THERAPY FOR WOMEN WITH POSTTRAUMATIC STRESS DISORDER: A RANDOMIZED NONINFERIORITY TRIAL
Author(s) -
Morland Leslie A.,
Mackintosh MargaretAnne,
Rosen Craig S.,
Willis Emy,
Resick Patricia,
Chard Kathleen,
Frueh B. Christopher
Publication year - 2015
Publication title -
depression and anxiety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.634
H-Index - 129
eISSN - 1520-6394
pISSN - 1091-4269
DOI - 10.1002/da.22397
Subject(s) - randomized controlled trial , medicine , telemedicine , cognitive behavioral therapy , cognitive therapy , mental health , psychiatry , posttraumatic stress , psychological intervention , clinical psychology , health care , economics , economic growth
Background This study examined the effectiveness of telemedicine to provide psychotherapy to women with posttraumatic stress disorder (PTSD) who might be unable to access treatment. Objectives were to compare clinical and process outcomes of PTSD treatment delivered via videoteleconferencing (VTC) and in‐person (NP) in an ethnically diverse sample of veteran and civilian women with PTSD. Methods A randomized controlled trial of Cognitive Processing Therapy, an evidence‐based intervention for PTSD, was conducted through a noninferiority design to compare delivery modalities on difference in posttreatment PTSD symptoms. Women with PTSD, including 21 veterans and 105 civilians, were assigned to receive psychotherapy delivered via VTC or NP. Primary treatment outcomes were changes in PTSD symptoms in the completer sample. Results Improvements in PTSD symptoms in the VTC condition ( n = 63) were noninferior to outcomes in the NP condition ( n = 63). Clinical outcomes obtained when both conditions were pooled together ( N = 126) demonstrated that PTSD symptoms declined substantially posttreatment (mean = −20.5, 95% CI −29.6 to −11.4) and gains were maintained at 3‐ (mean = −20.8, 95% CI −30.1 to −11.5) and 6‐month followup (mean = −22.0, 95% CI −33.1 to −10.9. Veterans demonstrated smaller symptom reductions posttreatment (mean = −9.4, 95% CI −22.5 to 3.7) than civilian women (mean = −22.7, 95% CI −29.9 to −15.5. Conclusions Providing psychotherapy to women with PTSD via VTC produced outcomes comparable to NP treatment. VTC can increase access to specialty mental health care for women in rural or remote areas.