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Cognitive processing therapy for posttraumatic stress disorder delivered to rural veterans via telemental health: a randomized noninferiority clinical trial.

Publication ,  Journal Article
Morland, LA; Mackintosh, M-A; Greene, CJ; Rosen, CS; Chard, KM; Resick, P; Frueh, BC
Published in: J Clin Psychiatry
May 2014

OBJECTIVE: To compare clinical and process outcomes of cognitive processing therapy-cognitive only version (CPT-C) delivered via videoteleconferencing (VTC) to in-person in a rural, ethnically diverse sample of veterans with posttraumatic stress disorder (PTSD). METHOD: A randomized clinical trial with a noninferiority design was used to determine if providing CPT-C via VTC is effective and "as good as" in-person delivery. The study took place between March 2009 and June 2013. PTSD was diagnosed per DSM-IV. Participants received 12 sessions of CPT-C via VTC (n = 61) or in-person (n = 64). Assessments were administered at baseline, midtreatment, immediately posttreatment, and 3 and 6 months posttreatment. The primary clinical outcome was posttreatment PTSD severity, as measured by the Clinician-Administered PTSD Scale. RESULTS: Clinical and process outcomes found VTC to be noninferior to in-person treatment. Significant reductions in PTSD symptoms were identified at posttreatment (Cohen d = 0.78, P < .05) and maintained at 3- and 6-month follow-up (d = 0.73, P < .05 and d = 0.76, P < .05, respectively). High levels of therapeutic alliance, treatment compliance, and satisfaction and moderate levels of treatment expectancies were reported, with no differences between groups (for all comparisons, F < 1.9, P > .17). CONCLUSIONS: Providing CPT-C to rural residents with PTSD via VTC produced outcomes that were "as good as" in-person treatment. All participants demonstrated significant reductions in PTSD symptoms posttreatment and at follow-up. Results indicate that VTC can offer increased access to specialty mental health care for residents of rural or remote areas. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT00879255.

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Published In

J Clin Psychiatry

DOI

EISSN

1555-2101

Publication Date

May 2014

Volume

75

Issue

5

Start / End Page

470 / 476

Location

United States

Related Subject Headings

  • Veterans
  • United States
  • Treatment Outcome
  • Telemedicine
  • Stress Disorders, Post-Traumatic
  • Severity of Illness Index
  • Rural Population
  • Psychotherapy, Group
  • Psychiatry
  • Prospective Studies
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Morland, L. A., Mackintosh, M.-A., Greene, C. J., Rosen, C. S., Chard, K. M., Resick, P., & Frueh, B. C. (2014). Cognitive processing therapy for posttraumatic stress disorder delivered to rural veterans via telemental health: a randomized noninferiority clinical trial. J Clin Psychiatry, 75(5), 470–476. https://doi.org/10.4088/JCP.13m08842
Morland, Leslie A., Margaret-Anne Mackintosh, Carolyn J. Greene, Craig S. Rosen, Kathleen M. Chard, Patricia Resick, and B Christopher Frueh. “Cognitive processing therapy for posttraumatic stress disorder delivered to rural veterans via telemental health: a randomized noninferiority clinical trial.J Clin Psychiatry 75, no. 5 (May 2014): 470–76. https://doi.org/10.4088/JCP.13m08842.
Morland LA, Mackintosh M-A, Greene CJ, Rosen CS, Chard KM, Resick P, et al. Cognitive processing therapy for posttraumatic stress disorder delivered to rural veterans via telemental health: a randomized noninferiority clinical trial. J Clin Psychiatry. 2014 May;75(5):470–6.
Morland, Leslie A., et al. “Cognitive processing therapy for posttraumatic stress disorder delivered to rural veterans via telemental health: a randomized noninferiority clinical trial.J Clin Psychiatry, vol. 75, no. 5, May 2014, pp. 470–76. Pubmed, doi:10.4088/JCP.13m08842.
Morland LA, Mackintosh M-A, Greene CJ, Rosen CS, Chard KM, Resick P, Frueh BC. Cognitive processing therapy for posttraumatic stress disorder delivered to rural veterans via telemental health: a randomized noninferiority clinical trial. J Clin Psychiatry. 2014 May;75(5):470–476.

Published In

J Clin Psychiatry

DOI

EISSN

1555-2101

Publication Date

May 2014

Volume

75

Issue

5

Start / End Page

470 / 476

Location

United States

Related Subject Headings

  • Veterans
  • United States
  • Treatment Outcome
  • Telemedicine
  • Stress Disorders, Post-Traumatic
  • Severity of Illness Index
  • Rural Population
  • Psychotherapy, Group
  • Psychiatry
  • Prospective Studies