A Pilot Study of Trauma-Focused Cognitive–Behavioral Therapy Delivered via Telehealth Technology

Abstract

Significant barriers exist in access to evidence-based, trauma-focused treatment among youth from economically disadvantaged backgrounds, those living in rural areas, and belonging to a racial and ethnic minority group, despite the high prevalence rates of trauma exposure among these underserved groups. The present study is proof-of-concept pilot of trauma-focused cognitive-behavioral therapy (TF-CBT) delivered to underserved trauma-exposed youth ( N = 15) via telehealth technology (i.e., via one-on-one videoconferencing), aimed at addressing barriers in access to TF treatment. This pilot study provides preliminary evidence of the ability to successfully deliver TF-CBT via a telehealth delivery format. Results demonstrated clinically meaningful symptom change posttreatment (large effect sizes for youth-reported ( d = 2.93) and caregiver-reported ( d = 1.38) reduction in posttraumatic stress disorder symptoms), with no treatment attrition (0% dropout). These findings are promising in showing treatment effects that are comparable with TF-CBT delivered in an in-person, office-based setting and an important first step in determining how to best address the mental health needs of trauma-exposed youth with barriers in access to care.

Fulfilling the promise of mental health technology to reduce public health disparities: Review and research agenda.

“…Most studies of videoconferencing-based services use slightly modified versions of established interventions and demonstrate effectiveness that is comparable to in-person services across multiple disorders, including depression, posttraumatic stress disorder (PTSD), anxiety disorders, and others (Fortney et al, 2015;Khatri, Marziali, Tchernikov, & Shepherd, 2014;Stewart, Orengo-Aguayo, Cohen, Mannarino, & de Arellano, 2017). While it is difficult to determine the effectiveness of telephone-based interventions due to low samples sizes and lack of recent studies, videoconferencing approaches are perhaps the best studied and most widely used of the various technological innovations.…”

“…Specifically, telemental health has shown high degrees of acceptability among many of these populations, including low-income, rural, and racial/ethnic minority groups (e.g., Stewart et al, 2017). The data that do exist have primarily examined the effectiveness and acceptability of each technology tool within a given underserved population.…”

“…While it is difficult to determine the effectiveness of telephone-based interventions due to low samples sizes and lack of recent studies, videoconferencing approaches are perhaps the best studied and most widely used of the various technological innovations. Most studies of videoconferencing-based services use slightly modified versions of established interventions and demonstrate effectiveness that is comparable to in-person services across multiple disorders, including depression, posttraumatic stress disorder (PTSD), anxiety disorders, and others (Fortney et al, 2015;Khatri, Marziali, Tchernikov, & Shepherd, 2014;Stewart, Orengo-Aguayo, Cohen, Mannarino, & de Arellano, 2017). 2.2 | Technology-mediated self-help…”

“…In general, this literature suggests several technology tools are both well-accepted and effective in multiple underserved populations. Specifically, telemental health has shown high degrees of acceptability among many of these populations, including low-income, rural, and racial/ethnic minority groups (e.g., Stewart et al, 2017). Investigations have also demonstrated the effectiveness of telemental health with underserved populations such as rural (Morland et al, 2014), Latinx (Chong & Moreno, 2012), Native American (Weiner, Rossetti, & Harrah, 2011), and Asian populations (Ye et al, 2012).…”

Accelerating Adoption of Patient-Facing Technologies in Clinical Trials: A Pharmaceutical Industry Perspective on Opportunities and Challenges

“…1,2 PT includes any digital technology with which patients interact to participate in health care or clinical activities. When implemented effectively, these technologies can be used to increase access to timely, quality, or specialty care [2][3][4][5][6][7] ; monitor disease progression 2,6 ; improve adherence to treatment regimens 8,9 ; and even improve patient outcomes. 2,6,[10][11][12][13] Despite gains in routine health care, adoption of PT as a mainstream tool remains limited in interventional clinical research and the pharmaceutical industry.…”