A non-inferiority trial of Prolonged Exposure for posttraumatic stress disorder: In person versus home-based telehealth

Abstract

This is the first randomized controlled trial to evaluate non-inferiority of Prolonged Exposure (PE) delivered via home-based telehealth (HBT) compared to standard in-person (IP) PE. One-hundred thirty two Veterans recruited from a Southeastern Veterans Affairs Medical Center and affiliated University who met criteria for posttraumatic stress disorder (PTSD) were randomized to receive PE via HBT or PE via IP. Results indicated that PE-HBT was non-inferior to PE-IP in terms of reducing PTSD scores at post-treatment, 3 and 6 month follow-up. However, non-inferiority hypotheses for depression were only supported at 6 month follow-up. HBT has great potential to reduce patient burden associated with receiving treatment in terms of travel time, travel cost, lost work, and stigma without sacrificing efficacy. These findings indicate that telehealth treatment delivered directly into patients’ homes may dramatically increase the reach of this evidence-based therapy for PTSD without diminishing effectiveness.

Residual Sleep Problems Predict Reduced Response to Prolonged Exposure among Veterans with PTSD

“…Post-intervention PCL scores yielded an average of 46.27 ( SD = 19.39; ranged from 17–85). For more description of the sample, please refer to the principal study by Acierno and colleagues (2017). Of the sample, 91% of the participants (N=136) positively endorsed sleep problems (Yes or No) for Criterion D of the PTSD DSM I diagnosis.…”

Predictors of Treatment Discontinuation During Prolonged Exposure for PTSD

“…Therapists met weekly with a senior-level PE trainer/therapist for supervision throughout the duration of the study. Treatment fidelity was maintained at or above 90% across and within conditions, assessed through random sampling of 20% of therapy session audiotapes rated according to session-specific procedures directly corresponding to the PE treatment manual (Acierno et al, 2017). Each therapist was randomly assigned to provide treatment to participants in both the in-person and telehealth conditions.…”

Cognitive‐behavioral therapy in the time of coronavirus: Clinician tips for working with eating disorders via telehealth when face‐to‐face meetings are not possible

“…Telehealth has been developed and shown to be effective broadly (Backhaus et al, 2012). It has also been demonstrated that its effects can be equivalent to those of face-to-face therapy in specific areas of mental health, such as post-traumatic stress disorder (Acierno et al, 2016(Acierno et al, , 2017Morland et al, 2014Morland et al, , 2015Yuen et al, 2015).…”