The purpose of this study is to establish the safety, feasibility, and acceptability of very brief imaginal exposure therapy for post-traumatic stress disorder (PTSD) delivered by telehealth over the course of six-daily 60-minute sessions within a 10-day window. All study visits occur remotely, by telehealth. You will be asked to complete a pre-treatment assessment involving a clinical interview, video-based measures of emotional and physical reactions, such as heart rate and breathing rate, and self-report questionnaires to measure the severity and impact of trauma-related symptoms. These assessments are completed again 1-week, and 1-month after completing treatment. The researchers propose that massed exposure-based therapy delivered via telehealth will advance telemental health treatment options and personalized care for Veterans with PTSD.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
OTHER
Masking
NONE
Consistent with Zoellner et al., (2017), six, 60-minute daily sessions of imaginal exposure will be conducted based on the PE manual (Foa et al., 2007). No in vivo exposure or homework will be included. Session 1 will include rationale for imaginal exposure and common reactions to trauma. Sessions 2-6 will focus on imaginal exposure (45 minutes) and processing (15 minutes), with later sessions focused on the most distressing aspect of the trauma memory. The final session will include relapse prevention. All sessions will be delivered within a 10-day window.
Adverse events
Potential adverse events will be assessed with a structured as well as open-ended interview daily during treatment and at follow up.
Time frame: from admission to 1 month follow up
Satisfaction with treatment - provider
PETQ: Prolonged exposure therapist questionnaire; scores range 0-30 with higher scores suggesting patient is more engaged in treatment.
Time frame: 1 week post-treatment
Satisfaction with telehealth - provider
TTSQ-Provider: Technology Treatment Satisfaction Questionnaire; scores range 0-30 with higher scores suggesting patient is more engaged in treatment
Time frame: 1 week post-treatment
Satisfaction with treatment - patient
STTSR: Satisfaction with Therapy and Therapist Scale-Revised; scores range 0-60 with higher scores indicating higher satisfaction
Time frame: 1 week post-treatment
Satisfaction with telehealth - patient
Technology Treatment Satisfaction Questionnaire; scores range 0-60 with higher scores indicating higher satisfaction.
Time frame: 1 week post-treatment
Number of sessions attended per patient
Number of telehealth therapy appointments attended per patient.
Time frame: from pre-treatment to 1-month follow-up
Rate of treatment completion and pre-mature dropout.
Total percent of patients retained from initial patients.
Time frame: from pre-treatment to 1-month follow-up
CAPS: Clinician-Administered PTSD Scale for DSM-5
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Structured interview for DSM-5 PTSD severity and impairment; Scores range from 0 to 80 with higher scores indicating greater PTSD severity and impairment.
Time frame: from pre-treatment to 1-month follow-up
PTSD symptom checklist
PCL-5: PTSD Symptom Checklist for DSM-5. Scores range from 0 to 80, with higher scores indicating greater PTSD severity and impairment.
Time frame: from pre-treatment to 1-month follow-up
Remote photoplethysmography
Video-based derivation of psychophysiology including heart rate and respiratory rate
Time frame: Pre-treatment, 1-week post-treatment, and 1-month follow-up.
Facial emotional expressivity
Video-based derivation of facial emotional expressivity.
Time frame: Pre-treatment, 1-week post-treatment, and 1-month follow-up.
Vocal and linguistic emotional expressivity
Audio-based derivation of vocal and linguistic emotional expressivity.
Time frame: Pre-treatment, 1-week post-treatment, and 1-month follow-up.