Distance-delivered interventions for PTSD: A systematic review and meta-analysis

- Distance CBT significantly reduced PTSD at post-treatment and follow-up.
- Post-treatment, Internet CBT led to superior PTSD outcomes vs. a waiting list.
- Post-treatment, videoconferencing had similar PTSD outcomes as face-to-face CBT.
- At follow-up, videoconferencing had inferior PTSD outcomes vs. face-to-face CBT.
- The quality of the evidence was moderate.

This systematic review and meta-analysis evaluated the efficacy of distance-delivered, guided approaches to treatment (e.g., delivered via telephone, Internet, mail, videoconferencing) for clinical and subclinical posttraumatic stress disorder (PTSD). A comprehensive search yielded 19 randomized controlled trials (1491 participants) to be included. Meta-analyses revealed that distance-delivered interventions led to significant within-group improvements in PTSD symptoms at post-treatment (g = 0.81, 95% CI 0.65 to 0.97) and 3-6 month follow-up (g = 0.78, 95% CI 0.59 to 0.97). Within-group depression and quality of life outcomes showed similar results, with medium post-treatment and follow-up effects. Compared to a waiting list, distance delivery (specifically, Internet treatments) led to superior PTSD outcomes (g = 0.68, 95% CI 0.51 to 0.86). Compared to face-to-face interventions, distance delivery (specifically, videoconferencing treatments) did not result in significantly different PTSD outcomes at post-treatment (g = −0.05, 95% CI −0.31 to 0.20) but led to inferior outcomes at 3-6 month follow-up (g = −0.25, 95% CI −0.44 to −0.07). Distance delivery of PTSD treatment is promising, but research is needed to determine its optimal use.