https://orcid.org/0000-0002-9596-6603
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ABSTRACT
Background: Research shows that veterans with mental health difficulties are reluctant to engage with treatment due to a number of practical and psychological barriers. Tele-therapy has been proposed as an alternative method of delivering therapy to ensure hard-to-reach groups receive the care they need.
Objective: This study aimed to explore the acceptability of using tele-therapy for treating PTSD in a sample of UK veterans.
Methods: Sixteen participants who had engaged with tele-therapy for PTSD were contacted following the cessation of their treatment, including those who had not completed the full course of therapy. Semi-structured qualitative interviews were conducted and the transcripts were analysed using thematic analysis.
Results: Five key themes emerged: Effect of your own environment, Importance of good therapeutic alliance, Technicalities and practicalities, Personal accountability and Measuring change. Effect of your own environment was described with sub-themes of control over your own environment, lack of support between sessions and snap back to reality. The Importance of good therapeutic alliance encompassed putting a face to the name, impersonal feeling and no different from being in the room. Technicalities and practicalities depicted good preparation is key, the flexibility of Skype, technical aspects and session length and timing. Personal accountability detailed finding the time and space, managing attendance and engagement and moving forward. Measuring change illustrated negative past experiences with therapy, improving self-recognition and managing symptoms.
Discussion: Tele-therapy appeared to be acceptable within this sample of veterans with many reporting overall positive experiences and improvements to their health. Future research is needed to foster a more supportive environment during and after therapy.
HIGHLIGHTS
• This article aimed to examine the acceptability of using tele-therapy for UK veterans with PTSD.• Overall positive experiences were reported with veterans commending the similarities of tele-therapy to face-to-face therapy, the flexibility, having control over their own environment and improvements in PTSD symptoms.• Difficulties faced included tele-therapy feeling impersonal, less support between sessions, technical difficulties and having to manage their own therapy time.• Given the new GDPR regulations, the use of Skype may need to be reconsidered in favour of more secure tele-therapy platforms.
Antecedentes: La investigación muestra que los veteranos con dificultades de salud mental son reticentes a comprometerse con un tratamiento debido a un número de barreras psicológicas y prácticas. La tele-terapia ha sido propuesta como un método alternativo de realizar terapia, para asegurar que grupos difíciles de alcanzar reciban el cuidado que necesitan.
Objetivo: Este estudio apuntó a explorar la aceptabilidad de usar tele-terapia para tratar TEPT en una muestra de veteranos del Reino Unido.
Métodos: Se contactó a 16 participantes que participaron en tele-terapia para TEPT, tras el cese de su tratamiento, incluyendo aquéllos que no completaron totalmente la terapia. Se realizaron entrevistas cualitativas semiestructuradas y las transcripciones se analizaron utilizando análisis temático.
Resultados: Surgieron cinco temas clave: Efecto de su propio ambiente, Importancia de una buena alianza terapéutica, Aspectos prácticos y tecnicismos, Responsabilidad personal, y Cambio medible. El efecto de su propio ambiente fue descrito con sub-temas de control sobre su propio ambiente, falta de apoyo entre sesiones y vuelta a la realidad. La importancia de una buena alianza terapéutica abarcó poner una cara al nombre, sentimientos impersonales, y no es diferente de estar en una habitación. Los Aspectos prácticos y tecnicismos indicaron que una buena preparación es clave, la flexibilidad de Skype, aspectos técnicos, duración y momento de la sesión. La responsabilidad personal destacó encontrar el tiempo y espacio, manejo de asistencia y compromiso y seguir adelante. Cambio medible ilustró experiencias pasadas negativas con terapias, mejorar el autoconocimiento y manejo de síntomas.
Discusión: La tele-terapia parece ser aceptable en esta muestra de veteranos con varios reportes de experiencias positivas y mejoras en su salud. Se necesita investigaciones futuras para fomentar un ambiente más alentador durante y después de la terapia.
背景：研究表明，由于一些实际和心理上的障碍，有心理健康困扰的退伍军人不愿意接受治疗。远程治疗可以作为替代方法，以确保远距离群体接受到他们所需的护理。
目的：本研究旨在探讨在英国退伍军人样本中使用远程疗法治疗PTSD的可接受性。
方法：16名接受PTSD远程治疗的被试，在其结束治疗后取得联系，其中包括那些未完成全程治疗的患者。对其进行半结构化定性访谈，并使用专题分析对转录本进行分析。
结果：出现了五个关键主题：自身环境的影响，良好治疗联盟的重要性，技术和实践，个人责任和测量变化。‘自身环境的影响’包括：对环境的控制，会话之间缺乏支持和跳跃回现实。‘良好治疗联盟的重要性’包括：面对名称（putting a face to the name），客观感觉，和在房间里一样（ no different from being in the room）。‘技术性和实用性’包括：良好的准备是关键，Skype的灵活性，技术方面，会话长度和时机。‘个人责任’具体包括：找到时间和场所，管理出勤和参与，向前进展。‘测量变化’包括：过去的负面治疗经验，改善自我认知和控制症状。
讨论：在退伍军人样本中远程治疗是可以接受的，其中许多人报告了整体积极的经历以及他们的健康状况得到了改善。未来的研究需要在治疗期间和治疗后培养更有利的环境。
Disclosure statement
No potential conflict of interest was reported by the authors.