title: Distance-delivered interventions for PTSD: A systematic review and meta-analysis.
abstract: This systematic review and meta-analysis evaluated the efficacy of distance-delivered, guided approaches to treatment (e.g., delivered via telephone, Internet, mail, videoconferencing) for clinical and subclinical posttraumatic stress disorder (PTSD). A comprehensive search yielded 19 randomized controlled trials (1491 participants) to be included. Meta-analyses revealed that distance-delivered interventions led to significant within-group improvements in PTSD symptoms at post-treatment (g=0.81, 95% CI 0.65 to 0.97) and 3-6 month follow-up (g=0.78, 95% CI 0.59 to 0.97). Within-group depression and quality of life outcomes showed similar results, with medium post-treatment and follow-up effects. Compared to a waiting list, distance delivery (specifically, Internet treatments) led to superior PTSD outcomes (g=0.68, 95% CI 0.51 to 0.86). Compared to face-to-face interventions, distance delivery (specifically, videoconferencing treatments) did not result in significantly different PTSD outcomes at post-treatment (g=-0.05, 95% CI -0.31 to 0.20) but led to inferior outcomes at 3-6 month follow-up (g=-0.25, 95% CI -0.44 to -0.07). Distance delivery of PTSD treatment is promising, but research is needed to determine its optimal use.
authors.affiliation: Department of Psychology, University of New Brunswick, PO Box 4400, Fredericton, NB, E3B 5A3, Canada. Electronic address: j.olthuis@unb.ca.
authors.forename: Janine V
authors.initials: JV
authors.lastname: Olthuis
authors.affiliation: Centre for Research in Family Health, IWK Health Centre, Halifax, NS. Electronic address: Lori.Wozney@iwk.nshealth.ca.
authors.forename: Lori
authors.initials: L
authors.lastname: Wozney
authors.affiliation: Department of Psychology, University of Regina, Regina, SK. Electronic address: gordon.asmundson@uregina.ca.
authors.forename: Gordon J G
authors.initials: GJ
authors.lastname: Asmundson
authors.affiliation: School of Rehabilitation Therapy, Queen's University, Kingston, ON. Electronic address: heidi.cramm@queensu.ca.
authors.forename: Heidi
authors.initials: H
authors.lastname: Cramm
authors.affiliation: Centre for Research in Family Health, IWK Health Centre, Halifax, NS; Department of Psychiatry, Dalhousie University, Canada. Electronic address: PPottie@strongestfamilies.com.
authors.forename: Patricia
authors.initials: P
authors.lastname: Lingley-Pottie
authors.affiliation: Departments of Psychiatry, Pediatrics, and Community Health and Epidemiology, Dalhousie University, Canada; IWK Health Centre and Nova Scotia Health Authority, Halifax, NS. Electronic address: Patrick.McGrath@nshealth.ca.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: McGrath
mesh_terms: D015928:Cognitive Behavioral Therapy / Q000379:methods*; D000068237:Distance Counseling / Q000379:methods*; D006801:Humans; D020407:Internet; D011788:Quality of Life / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome; D049269:Videoconferencing
keywords: Distance delivery; Internet; Posttraumatic stress disorder; Treatment; Videoconferencing