4.7 Article

Condensed Internet-delivered prolonged exposure provided soon after trauma: a randomised trial

Journal

PSYCHOLOGICAL MEDICINE
Volume 53, Issue 5, Pages 1989-1998

Publisher

CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0033291721003706

Keywords

early intervention; post-traumatic stress; prolonged exposure; the Internet; trauma

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This study evaluated the effectiveness of a novel, scalable and digital early version of an intervention called Condensed Internet-Delivered Prolonged Exposure (CIPE) in reducing post-traumatic stress symptoms. The results showed significant reductions in symptoms of post-traumatic stress in the CIPE group, with a moderate effect size at week 3 and a large effect size at week 7. The effects were maintained at the 6-month follow-up.
Background Exposure to trauma is common and can have a profoundly negative impact on mental health. Interventions based on trauma-focused cognitive behavioural therapy have shown promising results to facilitate recovery. The current trial evaluated whether a novel, scalable and digital early version of the intervention, Condensed Internet-Delivered Prolonged Exposure (CIPE), is effective in reducing post-traumatic stress symptoms. Method A single-site randomised controlled trial with self-referred adults (N = 102) exposed to trauma within the last 2 months. The participants were randomised to 3 weeks of CIPE or a waiting list (WL) for 7 weeks. Assessments were conducted at baseline, week 1-3 (primary endpoint), week 4-7 (secondary endpoint) and at 6-month follow-up. The primary outcome measure was PTSD Checklist for DSM-5 (PCL-5). Results The main analysis according to the intention-to-treat principle indicated statistically significant reductions in symptoms of post-traumatic stress in the CIPE group as compared to the WL group. The between-group effect size was moderate at week 3 (bootstrapped d = 0.70; 95% CI 0.33-1.06) and large at week 7 (bootstrapped d = 0.83; 95% CI 0.46-1.19). Results in the intervention group were maintained at the 6-month follow-up. No severe adverse events were found. Conclusions CIPE is a scalable intervention that may confer early benefits on post-traumatic stress symptoms in survivors of trauma. The next step is to compare this intervention to an active control group and also investigate its effects when implemented in regular care.

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