Acceptability of internet-based cognitive behavioural therapy (i-CBT) for post-traumatic stress disorder (PTSD): a systematic review

• Published in: European journal of psychotraumatology Vol. 10; no. 1; p. 1646092
• Main Authors: Simon, Natalie, McGillivray, Leah, Roberts, Neil P., Barawi, Kali, Lewis, Catrin E., Bisson, Jonathan I.
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 01-01-2019; Taylor & Francis Ltd; Taylor & Francis Group
• Subjects: Abandono de Pacientes; Adherencia y Cumplimiento del Tratamiento; Autoayuda Guiada; Behavior modification; cognitive behavioural therapy (CBT); Cognitive therapy; guided self help (GSH); Internet; Patient compliance; patient dropouts; Post traumatic stress disorder; post-traumatic; Postraumáticos; PTSD; Review; stress disorders; Systematic review; TEPT; Terapia Cognitivo Conductual; Trastorno de Estrés Postraumático; Trastornos de Estrés; treatment adherence and compliance; 创伤后应激障碍; 应激障碍，创伤后; 引导性自助; 患者脱落; 治疗依从性和依从性; 认知行为疗法; PTSD; cognitive behavioural therapy (CBT); post-traumatic; treatment adherence and compliance; stress disorders; Post-traumatic stress disorder; patient dropouts; guided self help (GSH); A review of acceptability of internet-delivered CBT (i-CBT) for PTSD.• I-CBT is a potentially acceptable psychological treatment for PTSD.• Small number of studies limits generalisability of findings.• Standardised, consistent acceptability measurement is needed
• ISSN: 2000-8066; 2000-8198; 2000-8066
• DOI: 10.1080/20008198.2019.1646092

Background: Internet-delivered Cognitive Behavioural Therapy (i-CBT) offers potential as an alternative, accessible, clinically and cost-effective treatment for post-traumatic stress disorder (PTSD), but little is known about its acceptability.
Objective: To review the available evidence to understand the acceptability of i-CBT for PTSD.
Method: We undertook a mixed-methods systematic review according to Cochrane Collaboration Guidelines, of randomised controlled trials (RCTs) of i-CBT for adults with PTSD. We examined included studies for measures of acceptability, and possible proxy indicators of acceptability, including dropout rates, which were meta-analysed as risk ratios (RRs).
Results: Ten studies with 720 participants were included. We found i-CBT to be acceptable according to specific acceptability measures, and suggestions for acceptability according to some proxy measures of i-CBT programme usage. There was, however, evidence of greater dropout from i-CBT than waitlist (RR 1.39, CI 1.03-1.88; 8 studies; participants = 585) and no evidence of a difference in dropout between i-CBT and i-non-CBT (RR 2.14, CI 0.97-4.73; participants = 132; 2 studies).
Conclusion: i-CBT appears a potentially acceptable intervention for adults with PTSD. We identified clinical and research questions, including the status of proxy indicators, and call for standardised, consistent treatment acceptability measurement.
* A review of acceptability of internet-delivered CBT (i-CBT) for PTSD.* I-CBT is a potentially acceptable psychological treatment for PTSD.* Small number of studies limits generalisability of findings.* Standardised, consistent acceptability measurement is needed.