Face to face but not in the same place: A pilot study of prolonged exposure therapy

ABSTRACT

This pilot study examined use of smartphone technology to deliver prolonged exposure (PE) therapy to patients with posttraumatic stress disorder (PTSD) with geographic limitations hindering in-person therapy. The primary goal was to examine the feasibility and acceptability of using video teleconferencing (i.e., computer-based and iPhone 4 streaming technology), with a secondary goal of examining clinical outcomes of PE delivered via teleconferencing compared with treatment as usual (TAU) on PTSD and depressive/anxious symptom reduction. Rural veterans (N = 27) were randomized to receive PE by computer teleconferencing at a Veterans Administration community clinic, PE by an iPhone issued for the duration of the study, or TAU provided by a referring clinician. To examine the research goals, we collected data on the number of referrals to the study, number of patients entering the study, and number completing psychotherapy and documented pragmatic and technical issues interfering with the ability to use teleconferencing to deliver PE; results are discussed. In addition, measures of symptom change examined clinical outcomes. Results indicated decreases in PTSD symptoms in veterans who completed PE therapy via teleconferencing; however, there was significantly more attrition in these groups than in the TAU group.

KEYWORDS:

• Exposure therapy
• posttraumatic stress disorder
• rural
• telehealth
• veterans

Acknowledgments

We would like to acknowledge the contributions of Ann Madison Tompkins, Leyla Manseur, and Kaitlyn McPhillips in helping prepare this article.

Funding

This research was funded by the Veterans Affairs South Central VA MIRECC Pilot Project Program, and the researchers used resources and facilities of the Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety (CIN13-413). The contents of this report do not represent the views of the Department of Veterans Affairs, the U.S. Government, or Baylor College of Medicine.

Additional information

Funding

This research was funded by the Veterans Affairs South Central VA MIRECC Pilot Project Program, and the researchers used resources and facilities of the Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety (CIN13-413). The contents of this report do not represent the views of the Department of Veterans Affairs, the U.S. Government, or Baylor College of Medicine.