Internet-delivered cognitive behavioural therapy for post-traumatic stress disorder: systematic review and meta-analysis



Lewis, C, Roberts, NP, Simon, N, Bethell, A ORCID: 0000-0002-6792-9143 and Bisson, JI
(2019) Internet-delivered cognitive behavioural therapy for post-traumatic stress disorder: systematic review and meta-analysis. ACTA PSYCHIATRICA SCANDINAVICA, 140 (6). pp. 508-521.

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Abstract

<h4>Objective</h4>To determine whether Internet-delivered cognitive behavioural therapy (i-CBT) is an effective treatment for those who meet diagnostic criteria for post-traumatic stress disorder (PTSD).<h4>Method</h4>A systematic review was undertaken according to Cochrane Collaboration Guidelines. The primary outcome measures were reduction in PTSD symptoms and drop-out. Categorical outcomes were meta-analysed as risk ratios (RRs) and continuous outcomes as mean differences (MDs) or standardised mean differences (SMDs).<h4>Results</h4>Ten studies with 720 participants were included. Evidence showed that i-CBT may be associated with a clinically important reduction in post-treatment PTSD symptoms compared with wait list (SMD -0.60, 95% confidence interval -0.97 to -0.24; N = 560); however, only three studies reported follow-up data, and there was no evidence to support the maintenance of symptom improvement at follow-up of 3-6 months. There was no evidence of a difference in PTSD symptoms between i-CBT and Internet-delivered non-CBT post-treatment. There was evidence of greater treatment effect from trauma-focused i-CBT than i-CBT without a trauma focus, as well as evidence that treatment effect was increased by the provision of guidance.<h4>Conclusions</h4>While the review found some beneficial effects of i-CBT for PTSD post-treatment, the quality of the evidence was very low because of the small number of included trials and there was insufficient evidence to support the maintenance of improvement at follow-up of 3-6 months. Further work is required to establish non-inferiority to current first-line interventions; to determine long-term efficacy; to explore mechanisms of effect; and to establish optimal levels of guidance.

Item Type: Article
Uncontrolled Keywords: cognitive behavioural therapy, guided self-help, stress disorders, post-traumatic
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences
Depositing User: Symplectic Admin
Date Deposited: 28 May 2021 08:52
Last Modified: 18 Jan 2023 22:37
DOI: 10.1111/acps.13079
Open Access URL: http://orca.cf.ac.uk/124516/
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3124335