Treatment Online

PTSD, Depression Sufferers Find Success with Web Based Treatment
> 11/2/2007 9:04:21 AM

An investigation undertaken by the Veterans Administration Boston Healthcare System and Boston University, and funded in large part by the NIMH, has found that an online self-treatment program was successful at treating post-traumatic stress disorder and depression in survivors of the 9/11 attacks and the war in Iraq. The researchers, led by Dr. Brett Litz, compared the progress of one group, who used an online cognitive behavioral therapy program, to another group, who received supportive therapy over the web. After eight weeks, both groups had shown improvement in PTSD and depressive symptoms, but the group participating in the self-management CBT had improved by a larger degree. At the six month check up, the CBT group displayed continued progress while the supportive therapy group had retained fewer of their previous gains.

Both of the programs examined in the study utilized the web as a tool for depression treatment and PTSD treatment�an idea that is gaining strength as of late�and it's a testament to the medium's viability as treatment deliverer that both groups saw improvements in the short run. Dr. Litz and his team addressed the study's strengths as well as some of its weaknesses in the report that was published in the American Journal of Psychiatry:

One-third of those who completed self-management cognitive behavior therapy achieved high end-state functioning 6 months after treatment. The intervention was tolerated well, and the dropout rate was similar to that of face-to-face trials. Because many military and emergency service personnel with PTSD often do not receive evidence-based treatment, these initial results point to a potentially viable means to deliver rapid and effective PTSD treatment to a large population with otherwise unmet needs for PTSD care.

These results are somewhat tempered by the fact that younger and more symptomatic service members were less likely to be located at 6 months (they were arguably more likely to be redeployed). Also, there was a tendency for fewer people to complete self-management cognitive behavior therapy than supportive counseling, and future research should study factors that enhance web usage for cognitive behavior therapy.

The researchers hit on two very important points in their discussion. First, many soldiers are not receiving any treatment, and these types of programs can reach that often under-served population. Secondly, the self-managed CBT program saw a higher amount of drop out, but still dropout commensurate with traditional treatment paradigms. What goes unsaid in each of these points is just as important: a system like those explored here could follow the soldiers on redeployment, and a different program that combined elements of both supportive and CBT-based systems may eliminate some of the problems with either individual program.

What this study demonstrates though, more than anything else, is that continued investigation has led to improvements in treatment administered online, and that in turn has led to higher expectations and higher potential outcomes for those in need. Beyond troops who don't receive treatment for PTSD, many other individuals and groups go untreated for reasons ranging from lack of practitioners to fear of stigmatization. Accessing treatment over the web can help alleviate these problems, and as this most recent study shows, it can also help alleviate the symptoms that call for treatment in the first place.