title: Face to face but not in the same place: A pilot study of prolonged exposure therapy.
abstract: This pilot study examined use of smartphone technology to deliver prolonged exposure (PE) therapy to patients with posttraumatic stress disorder (PTSD) with geographic limitations hindering in-person therapy. The primary goal was to examine the feasibility and acceptability of using video teleconferencing (i.e., computer-based and iPhone 4 streaming technology), with a secondary goal of examining clinical outcomes of PE delivered via teleconferencing compared with treatment as usual (TAU) on PTSD and depressive/anxious symptom reduction. Rural veterans (N = 27) were randomized to receive PE by computer teleconferencing at a Veterans Administration community clinic, PE by an iPhone issued for the duration of the study, or TAU provided by a referring clinician. To examine the research goals, we collected data on the number of referrals to the study, number of patients entering the study, and number completing psychotherapy and documented pragmatic and technical issues interfering with the ability to use teleconferencing to deliver PE; results are discussed. In addition, measures of symptom change examined clinical outcomes. Results indicated decreases in PTSD symptoms in veterans who completed PE therapy via teleconferencing; however, there was significantly more attrition in these groups than in the TAU group.
authors.affiliation: a Southeast Louisiana Veterans Health Care System , New Orleans , Louisiana , USA.|b South Central VA Mental Illness Research, Education, and Clinical Center , New Orleans , Louisiana , USA.|c Department of Psychiatry and Behavioral Sciences , Tulane University Medical School , New Orleans , Louisiana , USA.
authors.forename: C Laurel
authors.initials: CL
authors.lastname: Franklin
authors.affiliation: a Southeast Louisiana Veterans Health Care System , New Orleans , Louisiana , USA.
authors.forename: Lisa-Ann
authors.initials: LA
authors.lastname: Cuccurullo
authors.affiliation: a Southeast Louisiana Veterans Health Care System , New Orleans , Louisiana , USA.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Walton
authors.affiliation: a Southeast Louisiana Veterans Health Care System , New Orleans , Louisiana , USA.|c Department of Psychiatry and Behavioral Sciences , Tulane University Medical School , New Orleans , Louisiana , USA.
authors.forename: Julie R
authors.initials: JR
authors.lastname: Arseneau
authors.affiliation: d Michel E. Debakey VA Medical Center , Houston , Texas , USA.|e Department of Medicine , Baylor College of Medicine , Houston , Texas , USA.
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Petersen
mesh_terms: D000328:Adult; D040421:Cell Phone; D005260:Female; D006801:Humans; D007171:Implosive Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D013313:Stress Disorders, Post-Traumatic / Q000628:therapy*; D016896:Treatment Outcome; D014728:Veterans; D049269:Videoconferencing
keywords: Exposure therapy; posttraumatic stress disorder; rural; telehealth; veterans