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In-office, in-home, and telehealth cognitive processing therapy for posttraumatic stress disorder in veterans: a randomized clinical trial.

Publication ,  Journal Article
Peterson, AL; Mintz, J; Moring, JC; Straud, CL; Young-McCaughan, S; McGeary, CA; McGeary, DD; Litz, BT; Velligan, DI; Macdonald, A; Dillon, KH ...
Published in: BMC Psychiatry
January 17, 2022

BACKGROUND: Trauma-focused psychotherapies for combat-related posttraumatic stress disorder (PTSD) in military veterans are efficacious, but there are many barriers to receiving treatment. The objective of this study was to determine if cognitive processing therapy (CPT) for PTSD among active duty military personnel and veterans would result in increased acceptability, fewer dropouts, and better outcomes when delivered In-Home or by Telehealth as compared to In-Office treatment. METHODS: The trial used an equipoise-stratified randomization design in which participants (N = 120) could decline none or any 1 arm of the study and were then randomized equally to 1 of the remaining arms. Therapists delivered CPT in 12 sessions lasting 60-min each. Self-reported PTSD symptoms on the PTSD Checklist for DSM-5 (PCL-5) served as the primary outcome. RESULTS: Over half of the participants (57%) declined 1 treatment arm. Telehealth was the most acceptable and least often refused delivery format (17%), followed by In-Office (29%), and In-Home (54%); these differences were significant (p = 0.0008). Significant reductions in PTSD symptoms occurred with all treatment formats (p < .0001). Improvement on the PCL-5 was about twice as large in the In-Home (d = 2.1) and Telehealth (d = 2.0) formats than In-Office (d = 1.3); those differences were statistically large and significant (d = 0.8, 0.7 and p = 0.009, 0.014, respectively). There were no significant differences between In-Home and Telehealth outcomes (p = 0.77, d = -.08). Dropout from treatment was numerically lowest when therapy was delivered In-Home (25%) compared to Telehealth (34%) and In-Office (43%), but these differences were not statistically significant. CONCLUSIONS: CPT delivered by telehealth is an efficient and effective treatment modality for PTSD, especially considering in-person restrictions resulting from COVID-19. TRIAL REGISTRATION: ClinicalTrials.gov ID NCT02290847 (Registered 13/08/2014; First Posted Date 14/11/2014).

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Published In

BMC Psychiatry

DOI

EISSN

1471-244X

Publication Date

January 17, 2022

Volume

22

Issue

1

Start / End Page

41

Location

England

Related Subject Headings

  • Veterans
  • Treatment Outcome
  • Telemedicine
  • Stress Disorders, Post-Traumatic
  • SARS-CoV-2
  • Psychiatry
  • Military Personnel
  • Humans
  • Cognitive Behavioral Therapy
  • COVID-19
 

Citation

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Peterson, A. L., Mintz, J., Moring, J. C., Straud, C. L., Young-McCaughan, S., McGeary, C. A., … Resick, P. A. (2022). In-office, in-home, and telehealth cognitive processing therapy for posttraumatic stress disorder in veterans: a randomized clinical trial. BMC Psychiatry, 22(1), 41. https://doi.org/10.1186/s12888-022-03699-4
Peterson, Alan L., Jim Mintz, John C. Moring, Casey L. Straud, Stacey Young-McCaughan, Cindy A. McGeary, Donald D. McGeary, et al. “In-office, in-home, and telehealth cognitive processing therapy for posttraumatic stress disorder in veterans: a randomized clinical trial.BMC Psychiatry 22, no. 1 (January 17, 2022): 41. https://doi.org/10.1186/s12888-022-03699-4.
Peterson AL, Mintz J, Moring JC, Straud CL, Young-McCaughan S, McGeary CA, et al. In-office, in-home, and telehealth cognitive processing therapy for posttraumatic stress disorder in veterans: a randomized clinical trial. BMC Psychiatry. 2022 Jan 17;22(1):41.
Peterson, Alan L., et al. “In-office, in-home, and telehealth cognitive processing therapy for posttraumatic stress disorder in veterans: a randomized clinical trial.BMC Psychiatry, vol. 22, no. 1, Jan. 2022, p. 41. Pubmed, doi:10.1186/s12888-022-03699-4.
Peterson AL, Mintz J, Moring JC, Straud CL, Young-McCaughan S, McGeary CA, McGeary DD, Litz BT, Velligan DI, Macdonald A, Mata-Galan E, Holliday SL, Dillon KH, Roache JD, Bira LM, Nabity PS, Medellin EM, Hale WJ, Resick PA. In-office, in-home, and telehealth cognitive processing therapy for posttraumatic stress disorder in veterans: a randomized clinical trial. BMC Psychiatry. 2022 Jan 17;22(1):41.
Journal cover image

Published In

BMC Psychiatry

DOI

EISSN

1471-244X

Publication Date

January 17, 2022

Volume

22

Issue

1

Start / End Page

41

Location

England

Related Subject Headings

  • Veterans
  • Treatment Outcome
  • Telemedicine
  • Stress Disorders, Post-Traumatic
  • SARS-CoV-2
  • Psychiatry
  • Military Personnel
  • Humans
  • Cognitive Behavioral Therapy
  • COVID-19