Evidence Profile – posttraumatic stress disorder 1 Study 2 Study 3 Study 4 Authors and year Strachan, Gros, Ruggiero, Lejuez & Acierno (2012) Germain, Marchand, Bouchard, Drouin & Guay (2009) Tuerk, Yoder, Ruggiero, Gros & Acierno (2010) Gros, Yoder, Tuerk, Lozano & Acierno (2011) Design RCT Non-randomised controlled Non-randomised controlled trial Non-randomised controlled trial Intervention (I) and Comparison (C) (I): OVC (C): In-person treatment (I): OVC (C): In-person treatment (I): OVC (C): In-person treatment (I): OVC (C): In-person treatment Focus of Intervention Treatment (using Behaviour Activation therapy) Treatment (using CBT) Treatment (using exposure therapy) Treatment (using exposure therapy) Participant inclusion criteria Participants were included in the if they met criteria for PTSD or subthreshold PTSD, defined as fulfilment of Criteria A (traumatic event) and B and either C (avoidance) or D (hyperarousal) Participants were included in the study if they had a primary diagnosis of PTSD from the SCID-IV Participants were included in the study if they had been diagnosed with combat-related PTSD from the SCID-IV Participants were included in the study if they had been referred to receive exposure therapy for PTSD Primary outcome domain (measures) The time-by-treatment group interaction; to determine whether the change in PTSD symptoms over time was influenced by the treatment condition. - PCL-M, BDI-II, and BAI The time-by-treatment group interaction; to determine whether the change in PTSD symptoms over time was influenced by the treatment condition. Reduction in symptomology from pre- to post-treatment - PCL-M - BDI The time-by-treatment group interaction; to determine whether the change in PTSD symptoms over time was influenced by the treatment condition. - PCL-M - BDI - DASS - IIRS trial
Secondary outcome domain (measures) Change in symptomology over time: - Modified PTSD Symptom (MPSS) - BAI - BDI - Assessment of Current Functioning (ACF) Comfort with technology: - Distance Communication Comfort (DCCS) - Videoconferencing Telepresence Scale (VTS) - Videoconference Therapy Questionnaires (VT-Q) Change in symptomology over time: - PCL-M - BDI - DASS - IIRS Setting and sample characteristics American veterans with PTSD or subthreshold PTSD. N=31 (92.5% male, mean age of 30.4) Adults with PTSD. N=48 (39.6% male, mean age of 42.5) American veterans with combat-related PTSD. N=47 (94% male, mean age of 39). American veterans with PTSD. N=89 (~90% male, mean age of 45) Participants (I) N=18 N=16 N=12 N=62 Participants (C) N=13 No significant differences between the groups at baseline were reported. N=32 No significant differences between the groups at baseline were reported. N=35 No significant differences between the groups at baseline were reported. N=27 No significant differences between the groups at baseline were reported. Summary of the results A significant overall effect of time was observed, suggesting a decline in the frequency and A significant overall effect of time was observed, suggesting a decline in the frequency and Participants in both groups were found to experience significant clinical improvements over time. However, the effect size for the A significant overall effect of time was observed, suggesting a decline in the frequency and
severity of PTSD symptoms for both groups. The interaction term was not significant, suggesting that there was no difference between the two treatment conditions. severity of PTSD symptoms for both groups. The interaction term was not significant, suggesting that there was no difference between the two treatment conditions. group (d=4.2) was larger than that of the OVC group (d=2.9) severity of PTSD symptoms for both groups. However, the interaction term was significant, suggesting that clients receiving in-person treatment experienced a greater reduction in symptoms than those receiving OVC. Evidence Profile – therapeutic alliance 1 Study 2 Study 3 Study 4 Authors and year Day & Schneider (2002) Germain, Marchand, Bouchard, Guay & Drouin & (2010) Simpson, Guerrini & Rochford (2015) Richardson, Reid & Dziurawiec (2015) Design RCT Non-randomised controlled Non-randomised controlled trial Uncontrolled trial Intervention (I) and Comparison (C) (I): Three treatment groups: OVC, telephone, and in-person (C): Wait list (I): OVC (C): In-person treatment (I): OVC (C): In-person (I): OVC (C): none Focus of Intervention Treatment Treatment Treatment Treatment Participant inclusion criteria Clients in need of counselling Participants were included in the study if they had a primary diagnosis of PTSD from the SCID-IV Clients in need of counselling Clients receiving OVC
Primary outcome domain (measures) To determine whether ratings of the working alliance were influenced by the treatment condition. - Vanderbilt Psychotherapy Process Scale (VPPS) - CSS - TSS The time-by-treatment group interaction; to determine whether there was any change in alliance scores over time and whether this was influenced by the treatment condition. - WAI - SEQ - DCCS -VTS -VT-Q Reduction in symptomology from pre- to post-treatment - CORE-10 To evaluate the client experience of OVC - ARM Secondary outcome domain (measures) To determine whether clinical outcomes were influenced by the treatment condition. - BSI (GSI) - GAF - CSS - TSS To determine whether ratings of the working alliance were influenced by the treatment condition -CORE-ARM Setting and sample characteristics Clients receiving counselling for a variety of problems N=80 (35% male, mean age of 39.4) Adults with PTSD. N=46 (41.3% male, mean age of 42) Clients receiving counselling for a variety of problems N=23 Clients receiving counselling for a variety of problems Participants (I) OVC N=26; Telephone N=27; In-person N=27 N=17 N=6 (50% male, mean age=34) N=8 (25% male, ages ranged from 27 to 52 years) Participants (C) N=27 N=29 No significant differences between the groups at baseline were reported. N=17 (41% male, mean age=31.8) N/A Summary of the results There was a significant difference between the A significant overall effect of time was observed, Reductions in distress and high alliance scores Ratings of alliance were high from baseline and