The From Survivor to Thriver program: RCT of an online therapist-facilitated program for rape-related PTSD

Abstract

This study evaluated the efficacy of the From Survivor to Thriver program, an interactive, online therapist-facilitated cognitive-behavioral program for rape-related PTSD. Eighty-seven college women with rape-related PTSD were randomized to complete the interactive program (n = 46) or a psycho-educational self-help website (n = 41). Both programs led to large reductions in interview-assessed PTSD at post-treatment (interactive d = 2.22, psycho-educational d = 1.10), which were maintained at three month follow-up. Both also led to medium- to large-sized reductions in self-reported depressive and general anxiety symptoms. Follow-up analyses supported that the therapist-facilitated interactive program led to superior outcomes among those with higher pre-treatment PTSD whereas the psycho-educational self-help website led to superior outcomes for individuals with lower pre-treatment PTSD. Future research should examine the efficacy and effectiveness of online interventions for rape-related PTSD including whether treatment intensity matching could be utilized to maximize outcomes and therapist resource efficiency.

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

“…Only one study reported regular face‐to‐face therapist guidance , with the remainder of studies that reported therapist guidance indicating that it was delivered over the phone or via email/messaging service. Duration of treatment ranged from four to fourteen weeks . Five of the included studies evaluated trauma‐focused interventions; the remainder were non‐trauma‐focused.…”

“…Studies were conducted in the United States (six studies) , Australia (one study) , Iraq (one study) , Sweden (one study) and the United Kingdom (one study) . Studies included individuals traumatised by military combat ; living in a war zone (one study) ; and rape (one study) . The remainder of the studies included individuals traumatised by various traumatic events .…”

“…The remainder of the studies included individuals traumatised by various traumatic events . Six of the included studies determined PTSD diagnosis with a clinician‐administered scale , and four adopted a self‐report measure .…”

Acceptability of internet-based cognitive behavioural therapy (i-CBT) for post-traumatic stress disorder (PTSD): a systematic review

“…Studies compared i-CBT with a waitlist control group, treatment as usual (TAU) or minimal attention control group (k = 8), and with an i-non-CBT psychological intervention (k = 2). Studies were conducted in five countries: Australia (k = 1) (Spence et al, 2011); Iraq (k = 1) (Knaevelsrud, Brand, Lange, Ruwaard, & Wagner, 2015); Sweden (k = 1) (Ivarsson et al, 2014); UK (k = 1) (Lewis et al, 2017); and USA (k = 6) (Engel et al, 2015;Krupnick et al, 2017;Kuhn et al, 2017;Littleton, Grills, Kline, Schoemann, & Dodd, 2016, Litz et al, 2007Miner et al, 2016). Three studies recruited in clinical settings via clinician referrals (Engel et al, 2015;Krupnick et al, 2017;Lewis et al, 2017), these studies also recruited via media, website and promotional material advertising, which was the method used by the remaining seven studies.…”

“…Trauma type varied, with three studies concerning service members with military and terrorist-related trauma (Engel et al, 2015;Krupnick et al, 2017;Litz et al, 2007), and one study concerning civilians with warrelated trauma (Knaevelsrud et al, 2015), reporting moderate to severe PTSD symptoms, overall. Six studies reported individuals with fairly consistent PTSD severities of mild to moderate level, one study concerning rape trauma (Littleton et al, 2016), the others including a range of traumatic events taking place in the community (Ivarsson et al, 2014;Kuhn et al, 2017;Lewis et al, 2017;Miner et al, 2016;Spence et al, 2011).…”