Abstract
BackgroundThe present study was designed to evaluate the efficacy of an internet-based therapy (Interapy) for Posttraumatic Stress Disorder (PTSD) in a German speaking population. Also, the quality of the online therapeutic relationship, its development and its relevance as potential moderator of the treatment effects was investigated.MethodNinety-six patients with posttraumatic stress reactions were allocated at random to ten sessions of Internet-based cognitive behavioural therapy (CBT) conducted over a 5-week period or a waiting list control group. Severity of PTSD was the primary outcome. Secondary outcome variables were depression, anxiety, dissociation and physical health. Follow-up assessments were conducted at the end of treatment and 3 months after treatment.ResultsFrom baseline to post-treatment assessment, PTSD severity and other psychopathological symptoms were significantly improved for the treatment group (intent-to-treat group × time interaction effect size d = 1.40). Additionally, patients of the treatment condition showed significantly greater reduction of co-morbid depression and anxiety as compared to the waiting list condition. These effects were sustained during the 3-months follow-up period. High ratings of the therapeutic alliance and low drop-out rates indicated that a positive and stable therapeutic relationship could be established online. Significant improvement of the online working alliance in the course of treatment and a substantial correlation between the quality of the online relationship at the end of treatment and treatment outcome emerged.ConclusionInterapy proved to be a viable treatment alternative for PTSD with large effect sizes and sustained treatment effects. A stable and positive online therapeutic relationship can be established through the Internet which improved during the treatment process.Trial registrationAustralian Clinical Trials Registry ACTRN012606000401550
Highlights
The present study was designed to evaluate the efficacy of an internet-based therapy (Interapy) for Posttraumatic Stress Disorder (PTSD) in a German speaking population
From baseline to post-treatment assessment, PTSD severity and other psychopathological symptoms were significantly improved for the treatment group
A stable and positive online therapeutic relationship can be established through the Internet which improved during the treatment process
Summary
The present study was designed to evaluate the efficacy of an internet-based therapy (Interapy) for Posttraumatic Stress Disorder (PTSD) in a German speaking population. The Internet provides a protected environment where participants can control and regulate the degree of intimacy they want to share without the fear of real-life judgment, rejection, or devaluation This way of communication lessens social risks and inhibitions and encourages the disclosure of painful experiences or shameful thoughts [4,5,6]. Van de Werker and Prigerson [7] were among the first researchers to provide evidence on the protective effect of Internet use and email contact in bereaved individuals (N = 293) They explored the amount of Internet communication post loss at different time points and found that the use of the Internet served as a protection against psychiatric illness secondary to bereavement and that it enhanced quality of life
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