In this randomized clinical trial, researchers from the National Center for PTSD at the Veterans Affairs Pacific Islands Healthcare System in Honolulu, HI, examined outcomes from cognitive processing therapy delivered via video teleconferencing (VTC) as compared to in-person delivery, in a rural, ethnically diverse sample of veterans with posttraumatic stress disorder (PTSD).

Participants received 12 sessions of CPT-C via VTC (n = 61) or in-person (n = 64). Assessments were administered at baseline, mid-treatment, immediately post-treatment, and at 3 and 6 months post-treatment. The primary clinical outcome was post-treatment PTSD severity, as measured by the Clinician-Administered PTSD Scale or CAPS.

Clinical and process outcomes found VTC to be as effective as in-person treatment. Significant reductions in PTSD symptoms were identified at post-treatment (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).

The investigators conclude that 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 post-treatment and at follow-up. Results indicate that VTC can offer increased access to specialty mental health care for residents of rural or remote areas.

Citation:  Morland LA1, Mackintosh MA, 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. Journal of Clinical Psychiatry. 2014 May;75 (5): pp 470-6. [email protected]