Early intervention in post-traumatic stress disorder without exposure to trauma memories using internet-delivered cognitive therapy: A pilot case series
Thew G., Wild J., EHLERS A.
Objectives: Trauma-focused psychological interventions are the treatments of choice for posttraumatic stress disorder (PTSD). As many clinical services receive high demand for PTSD interventions, strategies to improve treatment efficiency are needed. Some people seek help in the early phase post-trauma, including as soon as the first few months. It is unclear whether all components of trauma-focused CBT are needed in this initial stage. Providing brief intervention in this early phase without work on trauma memories may be feasible and effective. This service evaluation study describes a case series of five participants experiencing PTSD following recent traumas. Methods: Participants completed a shortened 6-week form of internet-delivered Cognitive Therapy for PTSD (iCT-PTSD), which used fewer treatment modules and focused primarily on psychoeducation about PTSD, and two key treatment components, ‘reclaiming your life’ and trigger discrimination. Unlike the full course of iCT-PTSD, this format did not include working directly with trauma memories. Results: The intervention was associated with large reductions in symptoms of PTSD, depression, and anxiety at the six-week timepoint, which were maintained at three-month follow-up. Scores on the composite PTSD measure showed an average reduction of 91% between baseline and end of follow-up. One client required an extension to the weekly phase of treatment and received further treatment modules. All were discharged after follow-up and did not require further treatment. Conclusions: The findings provide preliminary evidence that this briefer format of iCT-PTSD was of benefit for those seeking support following recent traumas. Further examination in a larger controlled study is required.