The acceptability of a Guided Self-Help, internet-based trauma-focused cognitive behavioural therapy, for adults with mild to moderate Post Traumatic Stress Disorder (PTSD)

Simon, Natalie 2021. The acceptability of a Guided Self-Help, internet-based trauma-focused cognitive behavioural therapy, for adults with mild to moderate Post Traumatic Stress Disorder (PTSD). PhD Thesis, Cardiff University. Item availability restricted.

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Abstract

Guided Self-Help (GSH) internet-based Cognitive Behavioural Therapy (i-CBT) is an effective treatment for people with PTSD, recommended in treatment guidelines. Less is known about the acceptability of this relatively novel approach to PTSD treatment. There is some resistance towards the adoption of i-CBT, with some concerns about establishing therapeutic alliance. There is a drive towards improving access to psychological therapies, not least given the need for ‘pandemic-proof’ remote therapies. It may be timely to implement iCBT approaches at scale within the NHS. Knowledge of the acceptability of GSH iCBT for PTSD is required, alongside efficacy, for implementation and treatment decision making. A systematic review of the acceptability of i-CBT for PTSD was conducted. A Randomised Controlled Trial (RCT) compared the acceptability of GSH i-CBT with face-to-face Trauma-Focused CBT (TF-CBT), for adults with mild to moderate PTSD. Interviews were conducted with participants and therapists, and NHS commissioners and managers. GSH was found to be acceptable, comparable to face-to-face TF-CBT, across various facets of acceptability, including measures of adherence, satisfaction, therapeutic alliance, and qualitative interviews. RCT participant and therapist interviewees corroborated ratings and highlighted the importance of adapting GSH i-CBT to suit an individual’s needs and preferences. Interviews with NHS commissioners and managers revealed an openness to internet-based approaches and recommendations were offered to address implementation challenges. Further research is required, including examining the potential for GSH i-CBT for people with severe PTSD, and more complex presentations. Improved, robust methodology and dissemination of the multi-faceted construct of acceptability is needed. Shared decision making will help ensure GSH i-CBT is a treatment of choice, and encouragingly GSH i-CBT offers potential to be adaptable to meet the needs and preferences of different people. Practice-based evidence is required to continuously monitor the acceptability of GSH i-CBT for PTSD as it is delivered in routine care.

Item Type:	Thesis (PhD)
Date Type:	Completion
Status:	Unpublished
Schools:	Medicine
Date of First Compliant Deposit:	7 September 2021
Last Modified:	07 Sep 2021 14:33
URI:	https://orca.cardiff.ac.uk/id/eprint/143914

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