A randomized, controlled proof-of-concept trial of an Internet-based, therapist-assisted self-management treatment for posttraumatic stress disorder.
OBJECTIVE
The authors report an 8-week randomized, controlled proof-of-concept trial of a new therapist-assisted, Internet-based, self-management cognitive behavior therapy versus Internet-based supportive counseling for posttraumatic stress disorder (PTSD).


METHODS
Service members with PTSD from the attack on the Pentagon on September 11th or the Iraq War were randomly assigned to self-management cognitive behavior therapy (N=24) or supportive counseling (N=21).


RESULTS
The dropout rate was similar to regular cognitive behavior therapy (30%) and unrelated to treatment arm. In the intent-to-treat group, self-management cognitive behavior therapy led to sharper declines in daily log-on ratings of PTSD symptoms and global depression. In the completer group, self-management cognitive behavior therapy led to greater reductions in PTSD, depression, and anxiety scores at 6 months. One-third of those who completed self-management cognitive behavior therapy achieved high-end state functioning at 6 months.


CONCLUSIONS
Self-management cognitive behavior therapy may be a way of delivering effective treatment to large numbers with unmet needs and barriers to care.
Litz
Brett T
BT
National Center for PTSD Boston VA Healthcare System and Boston University School of Medicine, 150 South Huntington Ave., Boston, MA 01230, USA. brett.litz@va.gov
Engel
Charles C
CC
Bryant
Richard A
RA
Papa
Anthony
A
D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods* / Q000592:standards; D003130:Combat Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D003376:Counseling / Q000379:methods* / Q000592:standards; D005500:Follow-Up Studies; D006801:Humans; D020407:Internet; D007493:Iraq; D008297:Male; D008889:Military Personnel / Q000523:psychology; D010555:Personality Inventory; D015397:Program Evaluation; D011569:Psychiatric Status Rating Scales; D011615:Psychotherapy, Group; D012648:Self Care / Q000379:methods* / Q000592:standards; D047851:September 11 Terrorist Attacks / Q000523:psychology; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014857:Warfare