Internet‐based cognitive and behavioural therapies for post‐traumatic stress disorder (PTSD) in adults
Citation: Simon N, Robertson L, Lewis C, et al. Internet‐based cognitive and behavioural therapies for post‐traumatic stress disorder (PTSD) in adults. Cochrane Database of Systematic Reviews. 2021;(5):CD011710.
Language: Abstract available in EN, ES, FA, FR. Plain language summary available in EN, ES, FA, FR, JA, MS, PL, RU, ZH. Full text available in EN.
Free to view: Yes.
Funding sources: National Institute for Health Research (NIHR).
What is this? Internet-based therapy for post-traumatic stress disorder (PTSD) may provide a useful alternative when other therapies are not widely available or accessible.
In this Cochrane review, the authors searched for randomised trials of internet‐based cognitive and behavioural therapies (I-C/BT) for adults (>16 years) with PTSD. They did not restrict their searches by language or type of publication and did the search in June 2020. They included 13 randomised trials (808 participants), which were from Australia (2), Iraq (1), Sweden (2), UK (1) and USA (7). They also identified 21 ongoing studies.
What was found: Based on one included study, the authors concluded that there was very low-certainty evidence that I-C/BT was less effective than face-to-face non-C/BT in reducing PTSD post-treatment.
There was no evidence for a difference in post-treatment PTSD symptoms between I-C/BT and I-non-C/BT, but I-C/BT may be more effective than remaining on a waiting list for reducing PTSD symptoms, depression and anxiety (very low certainty evidence).
The cost-effectiveness of I-C/BT was unclear.
Implications: The authors of the review concluded that, although I-C/BT creates an opportunity to increase therapeutic capacity and optimise access to evidence‐based treatment, with several potential benefits, including reduced distress and improved functioning, the certainty of the available evidence was very low due to the small number of included studies. They stated that more research is needed into the effectiveness of I-C/BT compared with other therapies, the feasibility of using I-C/BT in low- and middle-income countries and methods to identify the most suitable candidates for such treatment.
Other considerations: The authors of the review discussed their findings in the context of race, education and place of residence (applicability to low- and middle-income countries).
This summary was prepared by Catherine Haynes, checked by Sydney Johnson, and finalized by Mike Clarke.