Group cognitive processing therapy delivered to veterans via telehealth: A pilot cohort

National Center for PTSD-Pacific Islands Division, Department of Veterans Affairs Pacific Islands Healthcare System, Honolulu, HI 96819, USA.
Journal of Traumatic Stress (Impact Factor: 2.72). 08/2011; 24(4):465-9. DOI: 10.1002/jts.20661
Source: PubMed


The authors report clinical findings from the pilot cohort of the first prospective, noninferiority-designed randomized clinical trial evaluating the clinical outcomes of delivering a cognitive-behavioral group intervention for posttraumatic stress disorder (PTSD), cognitive processing therapy (CPT), via video teleconferencing (VT) compared to the in-person modality. The treatment was delivered to 13 veterans with PTSD residing on the Hawaiian Islands. Results support the general feasibility and safety of using VT. Both groups showed clinically meaningful reductions in PTSD symptoms and no significant between-group differences on clinical or process outcome variables. In keeping with treatment manual recommendations, a few changes were made to the CPT protocol to accommodate this population. Novel aspects of this trial and lessons learned are discussed.

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    • "The use of technology can allow for interpersonal interactions to take place in a controlled, yet therapeutic environment. Studies among non-offender adult populations have shown that clinical (e.g., symptom reduction) and process (e.g., cohesion) outcomes remain intact when group therapy is conducted through TMH modalities such as videoconferencing (Greene et al. 2010; Morland et al. 2011). Finally, other TMH services like Web-based interventions, text message check-ins, or smartphone applications could be used to increase the intensity and accessibility of treatment for youth offenders (Kazdin and Blase 2011). "
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    ABSTRACT: The use of videoconferencing technology in the provision of mental health services is expected to increase rapidly over the next several years. Given the high rates of juvenile offenders in need of such services and the new norms of communication among young people in general, technology-based service modalities are a promising approach for increasing the availability and intensity of services, as well as engagement and compliance with treatment recommendations. This article will discuss the current state of the juvenile justice system, the literature on the use of telemental healthcare (TMH) with delinquent youth, how TMH fits within the generally accepted model of correctional rehabilitation, and special considerations for applying TMH to this population and setting. Although there is no evidence to suggest negative outcomes associated with TMH, future research is greatly needed to justify its use.
    Journal of child and adolescent psychopharmacology 08/2015; DOI:10.1089/cap.2015.0011 · 2.93 Impact Factor
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    • "Large effect sizes reported within group across treatment (telemental health d 5 2.9, in-person d 5 4.2) on PCL. Telemental health Morland et al. (2011) "
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    ABSTRACT: Cognitive-behavioral therapy (CBT) is currently the most empirically supported intervention for posttraumatic stress disorder (PTSD) and includes both specific manualized treatments (e.g., cognitive processing therapy, prolonged exposure) and less standardized applications. As CBT for PTSD has become increasingly popular, more advanced questions have emerged regarding its use, including how existing treatments might be enhanced. In the current review, we aimed to discover recent trends in the CBT for PTSD literature by applying rigorous search criteria to peer-reviewed articles published from 2009 to 2012. Results of the 14 studies that were identified are discussed, and future directions for research are suggested.
    CNS spectrums 02/2013; 18(2):1-9. DOI:10.1017/S1092852912000995 · 2.71 Impact Factor
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    • "In contrast, GBET data from multiple studies showed lower attrition (0%–5%). In addition, there was empirical and theoretical support for the effectiveness of group psychotherapy in the treatment of PTSD (Beck & Coffey, 2005; Morland, Hynes, Mackintosh, Resick, & Chard, 2011). Therefore, the Atlanta VA PTSD treatment program developed a modified version of GBET that used less group treatment time and that added the number of individual imaginal exposure (IE) sessions (6) that has been shown to ameliorate PTSD symptoms in some populations (e.g., Coffey, Stasiewicz, Hughes, & Brimo, 2006). "
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    ABSTRACT: Group-based exposure therapy (GBET) of 16-week duration was developed to treat combat-related posttraumatic stress disorder (PTSD) and decreased PTSD symptoms in 3 noncontrolled open trials with low attrition (0%-5%). Group-based exposure therapy has not produced as much PTSD symptom reduction as Prolonged Exposure (PE) within a U.S. Veterans Affairs PTSD treatment program, although PE had more dropouts (20%). This pilot study was of a model that combined key elements of GBET with components of PE in an effort to increase the effectiveness of a group-based treatment while reducing its length and maintaining low attrition. Twice per week, 8 Vietnam combat veterans with PTSD were treated for 12 weeks, with an intervention that included 2 within-group war trauma presentations per participant, 6 PE style individual imaginal exposure (IE) sessions per participant, daily listening to recorded IE sessions, and daily in vivo exposure exercises. All completed treatment and showed Significant reductions on all measures of PTSD with large effect sizes; 7 participants no longer met PTSD criteria on treating clinician administered interviews and a self-report measure at posttreatment. Significant reductions in depression with large effect sizes and moderate reductions in PTSD-related cognitions were also found. Most gains were maintained 6 months posttreatment.
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