Telehealth, or health care via videoconferencing, constitutes a clinical option that makes it possible to treat patients remotely. A growing number of studies have demonstrated that telehealth is a feasible and effective method for diagnostic interviews and psychiatric consultations. However, few studies have assessed the effectiveness of psychotherapy given by videoconference. This study examines the effectiveness of cognitive behavioural therapy (CBT) administered by videoconference for posttraumatic stress disorder (PTSD). Forty-eight participants with PTSD were recruited for the study: 16 in the videoconferencing condition and 32 in a control face-to-face condition. Each participant received CBT for 16 to 25 weeks and completed various questionnaires before and after treatment. The results show a significant decline in the frequency and severity of posttraumatic symptoms after treatment in both conditions. A clinical improvement in overall functioning was also observed. No significant difference was observed in the effectiveness of the two therapeutic conditions. The examination of effect sizes supports these results. A number of clinical implications and certain avenues for future research are discussed.

The objective of this study was to review the literature and make suggestions for further investigation into the topic of professionals' reactions following a patient's suicide. An extensive search of the literature has been undertaken using computer database search. Even if findings are heterogenous, most studies suggest limited stress-related or affective-related reactions for the majority of respondents. Whereas, findings with regards to the impact on professional practice are consistent in identifying important consequences in the way professionals conduct their clinical assessment and reach treatment decisions after a patient's suicide. Future research should investigate how this event changes the clinician's personal growth and capacity to establish a therapeutic alliance with other suicidal patients.

Until recently, only one study was published on cognitive-behavioral therapy (CBT) of posttraumatic stress disorder (PTSD) in individual therapy via videoconference (Germain, Marchand, Bouchard, Drouin, & Guay, 2009); however, it only assessed the posttreatment effect. This study presents the follow-up of Germain et al.'s (2009) study. The main goal was to compare the effectiveness after six months of CBT for PTSD either face-to-face (n = 24) or by videoconference (n = 12). Each participant received CBT for 16 to 25 weeks and completed various questionnaires before and after treatment and at a six-month follow-up. The two treatments had equivalent levels of symptom reduction (Modified PTSD Symptom Scale: η 2 < 0.01, p > .05) and proportion of patients with a clinically significant change in symptoms (42% for face-to-face vs. 38% for videoconferencing, p > .05). Thus, CBT for PTSD via videoconference seems to be a viable alternative when adequate face-to-face treatments are less available. CIHR Author Manuscript CIHR Author Manuscript CIHR Author ManuscriptCurrently, cognitive-behavioral therapy (CBT) is the most empirically validated treatment for posttraumatic stress disorder (PTSD); its efficacy was confirmed in two meta-analyses (Bradley, Greene, Russ, Dutra, & Westen, 2005;Van Etten & Taylor, 1998). However, access to state-of-the-art psychotherapy such as CBT treatment for PTSD is still limited and uneven. For example, it was shown that less than 20% of the hospitals in Canada had an anxiety disorders clinic and these clinics were mainly in urban areas (Swinson, Cos, Kerr, & Kuch, 1992). Similar situations can be expected in many industrialized countries. Access to these specialized services can therefore be problematic for individuals living outside major urban centers, and especially in rural regions. This uneven access to professional resources is also exacerbated by the fact that some people with severe or chronic problems cannot travel to the available resources for a variety of reasons (e.g., disability, avoidance behaviors, lack of energy; Riemer-Reiss, 2000).In that context, telepsychotherapy offered by videoconference constitutes an interesting solution. Videoconferencing is a technological procedure that allows individuals to see and hear each other on a computer monitor or video screen in real time. Hence, it enables individuals in different locations to interact simultaneously. Telepsychotherapy via videoconference can thus serve as a solution to provide these specialized services remotely, to mitigate the unequal distribution of resources, and to reduce the increasingly high cost of health care (Koocher & Morray, 2000;Riemer-Reiss, 2000). Moreover, telepsychotherapy opens up the possibility of offering psychological services to people who cannot travel to the places where the most effective health care services are located or cannot receive the services they need within a reasonable time period (Jerome et al., 2000). It can increase timely access to mental health care, while reducing t...

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Résumé Cet article rapporte les résultats d’une recherche réalisée auprès de 141 professionnels en santé mentale pratiquant au Québec et ayant vécu le suicide d’un patient. Les professionnels ont réagi à cet événement différemment en fonction de leur sexe. Les femmes y ont répondu par un niveau de stress élevé au cours du premier mois, alors que les hommes ont dévoilé un niveau de stress faible. Le niveau élevé de stress relevé chez les femmes était accompagné de répercussions initialement plus intenses sur leur pratique professionnelle : tendance accrue à hospitaliser des patients suicidaires ou précautions accrues dans leur traitement, évaluation d’un plus grand nombre de patients comme présentant un risque de suicide, sentiment accru d’impuissance lors de l’évaluation ou du traitement de patients suicidaires, consultation plus fréquente de collègues et de superviseurs, attention accrue aux aspects légaux dans la pratique. L’article tente de mieux comprendre les différences entre les réactions des professionnels observées selon leur sexe, à la lumière des théories de la socialisation et du développement professionnel.