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Key findings

For Veterans with PTSD, videoconferencing proves effective for delivering therapy

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Remote healing-PTSD therapy delivered through videoconferencing proved effective in one of the largest trials yet of the approach. Seen on the screen is study coordinator Janel Fidler of the VA San Diego Health Care System. (Photo by Christopher Menzie)
Remote healing—PTSD therapy delivered through videoconferencing proved effective in one of the largest trials yet of the approach. Seen on the screen is study coordinator Janel Fidler of the VA San Diego Health Care System. (Photo by Christopher Menzie)

Researchers at the Veterans Affairs San Diego Healthcare System who compared conventional in-person psychotherapy to therapy delivered through videoconferencing found that the video method worked just as well for treating posttraumatic stress disorder in Veterans.

The research team reported their results at the annual meeting of the Anxiety and Depression Association of America, held in April.

The study included 207 Veterans. It was one of the largest yet in VA to test new ways of delivering evidence-based psychotherapy for those with PTSD. Telemedicine approaches such as videoconferencing are critical for Veterans who live in rural areas far from VA medical centers.

"These new ways of delivering therapy are also important for Veterans with PTSD who do not feel comfortable driving, or who may feel uncomfortable in hospitals or other crowded places," added lead researcher Steven Thorp, PhD, a psychologist with VA and associate professor with the University of California, San Diego.

Thorp said the video equipment used is similar in some ways to consumer products such as Skype and FaceTime, but has better audio and video quality. He added that the transmissions are "encrypted to a higher standard so that even if they were intercepted, the data could not be interpreted. We use a very high standard to ensure that confidentiality is protected when we use this equipment."

The men and women in the study all received 12 weekly individual sessions of cognitive processing therapy. The treatment, developed in large part by Boston-based VA researcher Patricia Resick, PhD, helps patients change their negative thoughts, feelings, and beliefs surrounding the trauma they experienced. The treatment has been shown effective in past research, and VA has been teaching it on a wide scale to its therapists in recent years.

Half the Veterans in the study received the therapy in person at the main San Diego VA site in La Jolla. The others received it via videoconferencing at the VA Mission Valley Clinic, about 10 miles away. In some VA telemedicine studies, Veterans receive psychotherapy hundreds of miles away from a main clinical site, or even in their homes. In this study, the remote site was closer, but the researchers were still able to evaluate the long-distance technology.

Veterans in both groups showed significant reductions in their PTSD symptoms at three months, after treatment ended. Improvements among the in-person group were somewhat stronger. At a six-month follow-up, both groups showed equal gains.

The researchers also found no differences between the in-person and video groups in terms of patients’ and providers’ satisfaction with the therapy. Likewise, there was no difference in "alliance," or the therapeutic relationship between patients and counselors.

"Overall," said Thorp, "the results add to other research suggesting that telemedicine—particularly videoconferencing—is a safe, effective approach for Veterans with PTSD."

The study was funded by VA. The research team is with the VA Center of Excellence for Stress and Mental Health.



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