Internet-based treatments for trauma survivors

Last updated

Internet-based treatments for trauma survivors is a growing class of online treatments that allow for an individual who has experienced trauma to seek and receive treatment without needing to attend psychotherapy in person. The progressive movement to online resources and the need for more accessible mental health services has given rise to the creation of online-based interventions aimed to help those who have experienced traumatic events. [1] Cognitive behavioral therapy (CBT) has shown to be particularly effective in the treatment of trauma-related disorders and adapting CBT to an online format has been shown to be as effective as in-person CBT in the treatment of trauma. [2] [3] [4] [5] [6] [7] [8] Due to its positive outcomes, CBT-based internet treatment options for trauma survivors has been an expanding field in both research and clinical settings. [9]

Contents

Corinne-kutz-tMI2 -r5Nfo-unsplash.jpg

Background

Telepsychiatry in the form of teleconferencing dates back to 1959, when it was used for research and consultation at the University of Nebraska. [10] Then in 1968, successful emergency consultation services were provided via telehealth delivered in Boston and New Hampshire. [11] With the development of larger systems of operation, such as universities and federal health systems, telemental health services began seeing an uptake in research and randomized control trials in the 1990s. [12] Progress continued at a steady pace until 2003, when there was a notable change in the amount of advancement made in this area. [13] Despite early research and success in using telemental health in the treatment of disorders such as anxiety and behavioral problems, more recently, tailoring treatment for trauma survivors to an internet-based format has been gaining momentum. [14]

The growing interest in internet-based treatment options is a result of numerous factors. Convenience is one major reason for the creation and development of such formats. [15] [16] Internet-based treatment options allow for the user to choose when and where to access their program and can more easily fit treatment into their schedule, including after-hours treatment. [17] Anonymity is another reason why users would want to turn to such programs, especially if they feel embarrassed about their reasons for seeking help. [16] Cost-effectiveness, accessibility for those who live in more isolated or rural areas and for those of marginalized or minority populations are other reasons. [15] Furthermore, limitations occur that hinder people from attending in-person therapy, including childcare, transportation, or getting time off of work. [18] The development of internet-based treatment options allows individuals with these reasons or limitations to be able to access care without the need for in-person interaction.

Formats

Internet-based treatment options for trauma-related symptomology exist in the forms of healthcare-supported telehealth options, mobile applications (apps), online group and peer support, and online resources provided by organizations.  

Healthcare-supported telemental health

Healthcare providers who have mental health services mostly have online psychotherapy options available, especially as a result of the shift to telemental health in the wake of COVID-19. [19] These services can include both video and phone conferencing between professionals and clients. [20] These providers treat a wide variety of mental disorders, including trauma and stress-related disorders. Options that are available through healthcare providers can include individual therapy through therapist-supported teleconferencing, virtual support groups, and other self-guided online resources. [21]

Mobile apps

The advent of smartphone and tablet apps has allowed for an easily accessible platform that an individual can use flexibly within their own schedule. [22] The Department of Veteran's Affairs (VA)’s National Center for PTSD has developed fifteen mobile apps, including seven apps that are designed to be used with a clinician, and eight self-guided apps that can be used either with or without a clinician. [23] One of these apps, PTSD Coach, is the most well-known mobile app for treating PTSD and has been shown to be an acceptable intervention for those displaying PTSD symptoms. [24] [25] A growing number of mobile apps exist to aid in trauma-care and the high-quality and evidence-based apps have been found to be beneficial. [26] [27]

Group support

Videoconferencing telehealth group-based treatment options for trauma survivors have also been shown to be effective. [28] [29] Group support options can come in different forms, including health professional-assisted group sessions and peer-to-peer support. [28] Furthermore, countless trauma and PTSD support groups exist online and have been found to be effective in lessening stress, depression, and trauma-related symptoms. [30] [31] Mobile app group and peer support have also become available and have been shown to be effective, as well. [32] [33]

Additional online resources

Additional organization websites also provide psychoeducation and other resources for children, adolescents, and adults, including the Substance Abuse and Mental Health Services Administration (SAMHSA) and other branches of the U.S. Department of Health and Human Services (HHS). [34] Organizations and websites that provide information for opportunities to participate in research studies exist as well, including the International Society for Traumatic Stress Studies (ISTSS) and ClinicalTrials.gov. [35] [36]

Alternatives to CBT-based treatments

Other treatment approaches can be found online, as well, including cognitive therapy for post-traumatic stress disorder (CT-PTSD). [37] Eye Movement Desensitization and Reprocessing (EDMR) has been integrated into twelve mobile apps, though only six have been found to be acceptable to use in conjunction with a professional. [38]

Though CBT has a mindfulness component, there are apps that are being specially developed to only focus on mindfulness as a means to aid in trauma-care, including one developed by the VA's National Center for PTSD called Mindfulness Coach. [39] Prevention programs are also in the early stages of development and are aimed at high risk populations. [40]

Drawbacks of internet-based interventions

Though there are numerous advantages for the development and growth of internet-based interventions for trauma, there are also situations in which telehealth might not be beneficial. Children in abusive households could have trouble benefiting from telemental health options in that they may not have the ability to recognize dissociative symptoms, may not have a private space, may not be able to process their trauma when they are not in a safe space, and may not be able to pay attention due to emotion regulation problems. [14] Similar patterns can also be seen in adult populations as well, such as during COVID-19-related shelter-in-place orders that have impacted victims of domestic violence. [41]

Other factors can contribute to an individual's inability to use internet-based resources, including individuals of lower socioeconomic status who may not be able to afford smartphones, computers, or other devices. [42] Poor internet connections have also been a barrier to accessing care via the internet and can be a result of geographic location and internet plans. [42] Older individuals and those with disabilities, such as the hearing and vision impaired, can also be at a disadvantage. [42]

Another consideration with internet-based treatment options is the dropout rate. Similar to the dropout rates for using internet-based treatment options for other mental disorders, online trauma-focused interventions appear to have a generally high dropout rate, with a range of between 15 and 41% dropout rates during clinical trials. [27] [43] The gamification, or use of gaming elements, of mental health apps is one approach to addressing this issue and has been gaining support for improving adherence to app programs, as well as increasing resiliency. [44]

Related Research Articles

<span class="mw-page-title-main">Cognitive behavioral therapy</span> Therapy to improve mental health

Cognitive behavioral therapy (CBT) is a psycho-social intervention that aims to reduce symptoms of various mental health conditions, primarily depression and anxiety disorders. Cognitive behavioral therapy is one of the most effective means of treatment for substance abuse and co-occurring mental health disorders. CBT focuses on challenging and changing cognitive distortions and their associated behaviors to improve emotional regulation and develop personal coping strategies that target solving current problems. Though it was originally designed to treat depression, its uses have been expanded to include many issues and the treatment of many mental health conditions, including anxiety, substance use disorders, marital problems, ADHD, and eating disorders. CBT includes a number of cognitive or behavioral psychotherapies that treat defined psychopathologies using evidence-based techniques and strategies.

<span class="mw-page-title-main">Anxiety disorder</span> Cognitive disorder with an excessive, irrational dread of everyday situations

Anxiety disorders are a cluster of mental disorders characterized by significant and uncontrollable feelings of anxiety and fear such that a person's social, occupational, and personal functions are significantly impaired. Anxiety may cause physical and cognitive symptoms, such as restlessness, irritability, easy fatigue, difficulty concentrating, increased heart rate, chest pain, abdominal pain, and a variety of other symptoms that may vary based on the individual.

Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that develops from experiencing a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on a person's life or well-being. Symptoms may include disturbing thoughts, feelings, or dreams related to the events, mental or physical distress to trauma-related cues, attempts to avoid trauma-related cues, alterations in the way a person thinks and feels, and an increase in the fight-or-flight response. These symptoms last for more than a month after the event. Young children are less likely to show distress, but instead may express their memories through play. A person with PTSD is at a higher risk of suicide and intentional self-harm.

<span class="mw-page-title-main">Dialectical behavior therapy</span> Psychotherapy for emotional dysregulation

Dialectical behavior therapy (DBT) is an evidence-based psychotherapy that began with efforts to treat personality disorders and interpersonal conflicts. Evidence suggests that DBT can be useful in treating mood disorders and suicidal ideation as well as for changing behavioral patterns such as self-harm and substance use. DBT evolved into a process in which the therapist and client work with acceptance and change-oriented strategies and ultimately balance and synthesize them—comparable to the philosophical dialectical process of thesis and antithesis, followed by synthesis.

Psychological trauma is an emotional response caused by severe distressing events that are outside the normal range of human experiences, with extreme examples being violence, rape, or a terrorist attack. The event must be understood by the affected person as directly threatening the affected person or their loved ones with death, severe bodily injury, or sexual violence; indirect exposure, such as from watching television news, may be extremely distressing and can produce an involuntary and possibly overwhelming physiological stress response, but does not produce trauma per se.

Eye movement desensitization and reprocessing (EMDR) is a form of psychotherapy that is controversial within the psychological community. It was devised by Francine Shapiro in 1987 and originally designed to alleviate the distress associated with traumatic memories such as post-traumatic stress disorder (PTSD).

Complex post-traumatic stress disorder (CPTSD) is a stress-related mental disorder generally occurring in response to complex traumas, i.e., commonly prolonged or repetitive exposures to a series of traumatic events, within which individuals perceive little or no chance to escape.

<span class="mw-page-title-main">Psychological intervention</span>

In applied psychology, interventions are actions performed to bring about change in people. A wide range of intervention strategies exist and they are directed towards various types of issues. Most generally, it means any activities used to modify behavior, emotional state, or feelings. Psychological interventions have many different applications and the most common use is for the treatment of mental disorders, most commonly using psychotherapy. The ultimate goal behind these interventions is not only to alleviate symptoms but also to target the root cause of mental disorders.

Childhood trauma is often described as serious adverse childhood experiences (ACEs). Children may go through a range of experiences that classify as psychological trauma; these might include neglect, abandonment, sexual abuse, emotional abuse, and physical abuse, witnessing abuse of a sibling or parent, or having a mentally ill parent. These events have profound psychological, physiological, and sociological impacts and can have negative, lasting effects on health and well-being such as unsocial behaviors, attention deficit hyperactivity disorder (ADHD), and sleep disturbances. Similarly, children whose mothers have experienced traumatic or stressful events during pregnancy have an increased risk of mental health disorders and other neurodevelopmental disorders.

Prolonged exposure therapy (PE) is a form of behavior therapy and cognitive behavioral therapy designed to treat post-traumatic stress disorder. It is characterized by two main treatment procedures – imaginal and in vivo exposures. Imaginal exposure is repeated 'on-purpose' retelling of the trauma memory. In vivo exposure is gradually confronting situations, places, and things that are reminders of the trauma or feel dangerous. Additional procedures include processing of the trauma memory and breathing retraining.

Cognitive behavioral therapy for insomnia (CBT-I) is a technique for treating insomnia without medications. Insomnia is a common problem involving trouble falling asleep, staying asleep, or getting quality sleep. CBT-I aims to improve sleep habits and behaviors by identifying and changing the thoughts and the behaviors that affect the ability of a person to sleep or sleep well.

The use of electronic and communication technologies as a therapeutic aid to healthcare practices is commonly referred to as telemedicine or eHealth. The use of such technologies as a supplement to mainstream therapies for mental disorders is an emerging mental health treatment field which, it is argued, could improve the accessibility, effectiveness and affordability of mental health care. Mental health technologies used by professionals as an adjunct to mainstream clinical practices include email, SMS, virtual reality, computer programs, blogs, social networks, the telephone, video conferencing, computer games, instant messaging and podcasts.

PTSD or post-traumatic stress disorder, is a psychiatric disorder characterised by intrusive thoughts and memories, dreams or flashbacks of the event; avoidance of people, places and activities that remind the individual of the event; ongoing negative beliefs about oneself or the world, mood changes and persistent feelings of anger, guilt or fear; alterations in arousal such as increased irritability, angry outbursts, being hypervigilant, or having difficulty with concentration and sleep.

Trauma focused cognitive behavioral therapy (TF-CBT) is an evidence-based psychotherapy or counselling that aims at addressing the needs of children and adolescents with post traumatic stress disorder (PTSD) and other difficulties related to traumatic life events. This treatment was developed and proposed by Drs. Anthony Mannarino, Judith Cohen, and Esther Deblinger in 2006. The goal of TF-CBT is to provide psychoeducation to both the child and non-offending caregivers, then help them identify, cope, and re-regulate maladaptive emotions, thoughts, and behaviors. Research has shown TF-CBT to be effective in treating childhood PTSD and with children who have experienced or witnessed traumatic events, including but not limited to physical or sexual victimization, child maltreatment, domestic violence, community violence, accidents, natural disasters, and war. More recently, TF-CBT has been applied to and found effective in treating complex posttraumatic stress disorder.

Metacognitive therapy (MCT) is a psychotherapy focused on modifying metacognitive beliefs that perpetuate states of worry, rumination and attention fixation. It was created by Adrian Wells based on an information processing model by Wells and Gerald Matthews. It is supported by scientific evidence from a large number of studies.

<span class="mw-page-title-main">Trauma and first responders</span> Trauma experienced by first responders

Trauma in first responders refers to the psychological trauma experienced by first responders, such as police officers, firefighters, and paramedics, often as a result of events experienced in their line of work. The nature of a first responder's occupation continuously puts them in harm's way and regularly exposes them to traumatic situations, such as people who have been harmed, injured, or killed.

PTSD treatment In South Africa arose to treat the victims of physical violence and sexual abuse, who often display symptoms of post-traumatic stress disorder (PTSD).

Sexual trauma therapy is medical and psychological interventions provided to survivors of sexual violence aiming to treat their physical injuries and cope with mental trauma caused by the event. Examples of sexual violence include any acts of unwanted sexual actions like sexual harassment, groping, rape, and circulation of sexual content without consent.

Being exposed to traumatic events such as war, violence, disasters, loss, injury or illness can cause trauma. Additionally, the most common diagnostic instruments such as the ICD-11 and the DSM-5 expand on this definition of trauma to include perceived threat to death, injury, or sexual violence to self or a loved one. Even after the situation has passed, the experience can bring up a sense of vulnerability, hopelessness, anger and fear.

Trauma and post-traumatic stress disorder (PTSD) in Asian Americans is a growing topic related to trauma and racial psychology that requires more attention and research.

References

  1. ↑ Ruzek, J. I.; Yeager, C. M. (2017). "Internet and mobile technologies: addressing the mental health of trauma survivors in less resourced communities". Global Mental Health. 4: e16. doi:10.1017/gmh.2017.11. PMC   5719483 . PMID   29230312.
  2. ↑ Hofmann, Stefan G.; Smits, Jasper A. J. (2008). "Cognitive-behavioral therapy for adult anxiety disorders: A meta-analysis of randomized placebo-controlled trials". The Journal of Clinical Psychiatry. 69 (4): 621–632. doi:10.4088/jcp.v69n0415. PMC   2409267 . PMID   18363421.
  3. ↑ Lewis, Catrin; Roberts, Neil P; Bethell, Andrew; Robertson, Lindsay; Bisson, Jonathan I (2018). "Internet-based cognitive and behavioural therapies for post-traumatic stress disorder (PTSD) in adults". Cochrane Database of Systematic Reviews. 12 (12): CD011710. doi:10.1002/14651858.cd011710.pub2. PMC   6516951 . PMID   30550643.
  4. ↑ McDonagh, Annmarie; Friedman, Matthew; McHugo, Gregory; Ford, Julian; Sengupta, Anjana; Mueser, Kim; Demment, Christine Carney; Fournier, Debra; Schnurr, Paula P.; Descamps, Monica (2005). "Randomized trial of cognitive-behavioral therapy for chronic posttraumatic stress disorder in adult female survivors of childhood sexual abuse". Journal of Consulting and Clinical Psychology. 73 (3): 515–524. doi:10.1037/0022-006X.73.3.515. PMID   15982149.
  5. ↑ Mewton, Louise; Smith, Jessica; Rossouw, Pieter; Andrews, Gavin (2014). "Current perspectives on Internet-delivered cognitive behavioral therapy for adults with anxiety and related disorders". Psychology Research and Behavior Management. 7: 37–46. doi: 10.2147/PRBM.S40879 . PMC   3913603 . PMID   24511246.
  6. ↑ Smith, Patrick; Yule, William; Perrin, Sean; Tranah, Troy; Dalgleish, Tim; Clark, David M. (2007). "Cognitive-Behavioral Therapy for PTSD in Children and Adolescents: A Preliminary Randomized Controlled Trial". Journal of the American Academy of Child & Adolescent Psychiatry. 46 (8): 1051–1061. doi:10.1097/chi.0b013e318067e288. PMID   17667483.
  7. ↑ "Online CBT for post-traumatic stress disorder is as effective as face-to-face therapy". NIHR Evidence. 27 January 2023. doi:10.3310/nihrevidence_56507. S2CID   257844874.
  8. ↑ Bisson, Jonathan I.; Ariti, Cono; Cullen, Katherine; Kitchiner, Neil; Lewis, Catrin; Roberts, Neil P.; Simon, Natalie; Smallman, Kim; Addison, Katy; Bell, Vicky; Brookes-Howell, Lucy; Cosgrove, Sarah; Ehlers, Anke; Fitzsimmons, Deborah; Foscarini-Craggs, Paula (2022-06-16). "Guided, internet based, cognitive behavioural therapy for post-traumatic stress disorder: pragmatic, multicentre, randomised controlled non-inferiority trial (RAPID)". BMJ. 377: e069405. doi:10.1136/bmj-2021-069405. ISSN   1756-1833. PMC   9202033 . PMID   35710124.
  9. ↑ Kumar, Vikram; Sattar, Yasar; Bseiso, Anan; Khan, Sara; Rutkofsky, Ian H (2017). "The Effectiveness of Internet-Based Cognitive Behavioral Therapy in Treatment of Psychiatric Disorders". Cureus. 9 (8): e1626. doi: 10.7759/cureus.1626 . ISSN   2168-8184. PMC   5659300 . PMID   29098136.
  10. ↑ Shore, Jay (2015). "The evolution and history of telepsychiatry and its impact on psychiatric care: Current implications for psychiatrists and psychiatric organizations". International Review of Psychiatry. 27 (6): 469–475. doi:10.3109/09540261.2015.1072086. PMID   26397182. S2CID   27058053.
  11. ↑ Smith, Henry (1998). "TELEMENTAL HEALTH: Delivering Mental Health Care at a Distance" (PDF).
  12. ↑ Shore, Jay (2015-11-02). "The evolution and history of telepsychiatry and its impact on psychiatric care: Current implications for psychiatrists and psychiatric organizations". International Review of Psychiatry. 27 (6): 469–475. doi:10.3109/09540261.2015.1072086. PMID   26397182. S2CID   27058053.
  13. ↑ Hilty, Donald M.; Ferrer, Daphne C.; Parish, Michelle Burke; Johnston, Barb; Callahan, Edward J.; Yellowlees, Peter M. (2013-05-22). "The Effectiveness of Telemental Health: A 2013 Review". Telemedicine and e-Health. 19 (6): 444–454. doi:10.1089/tmj.2013.0075. PMC   3662387 . PMID   23697504.
  14. 1 2 Racine, Nicole; Hartwick, Cailey; Collin-Vézina, Delphine; Madigan, Sheri (2020-08-19). "Telemental health for child trauma treatment during and post-COVID-19: Limitations and considerations". Child Abuse & Neglect. 110 (Pt 2): 104698. doi:10.1016/j.chiabu.2020.104698. PMC   7437482 . PMID   32839022.
  15. 1 2 Barak, Azy; Grohol, John M. (2011). "Current and Future Trends in Internet-Supported Mental Health Interventions". Journal of Technology in Human Services. 29 (3): 155–196. doi:10.1080/15228835.2011.616939. S2CID   144160895.
  16. 1 2 White, Angela; Kavanagh, David; Stallman, Helen; Klein, Britt; Kay-Lambkin, Frances; Proudfoot, Judy; Drennan, Judy; Connor, Jason; Baker, Amanda; Hines, Emily; Young, Ross (2010-12-19). "Online Alcohol Interventions: A Systematic Review". Journal of Medical Internet Research. 12 (5): e62. doi: 10.2196/jmir.1479 . PMC   3057310 . PMID   21169175.
  17. ↑ Jones, Andrea M.; Shealy, Kristen M.; Reid-Quiñones, Kathryn; Moreland, Angela D.; Davidson, Tatiana M.; López, Cristina M.; Barr, Simone C.; de Arellano, Michael A. (2014). "Guidelines for Establishing a Telemental Health Program to Provide Evidence-Based Therapy for Trauma-Exposed Children and Families". Psychological Services. 11 (4): 398–409. doi:10.1037/a0034963. PMC   4079762 . PMID   24320994.
  18. ↑ Lewis, Catrin; Roberts, Neil P; Bethell, Andrew; Robertson, Lindsay; Bisson, Jonathan I (2018-12-14). "Internet-based cognitive and behavioural therapies for post-traumatic stress disorder (PTSD) in adults". Cochrane Database of Systematic Reviews. 12 (12): CD011710. doi:10.1002/14651858.cd011710.pub2. PMC   6516951 . PMID   30550643.
  19. ↑ Gerber, Megan R.; Elisseou, Sadie; Sager, Zachary S.; Keith, Jessica A. (2020). "Trauma-Informed Telehealth in the COVID-19 Era and Beyond". Federal Practitioner. 37 (7): 302–308. PMC   7473719 . PMID   32908333.
  20. ↑ Deslich, Stacie; Stec, Bruce; Tomblin, Shane; Coustasse, Alberto (2013-07-01). "Telepsychiatry in the 21st Century: Transforming Healthcare with Technology". Perspectives in Health Information Management / AHIMA, American Health Information Management Association. 10 (Summer): 1f. ISSN   1559-4122. PMC   3709879 . PMID   23861676.
  21. ↑ Olthuis, Janine V; Watt, Margo C; Bailey, Kristen; Hayden, Jill A; Stewart, Sherry H (2016-03-12). "Therapist-supported Internet cognitive behavioural therapy for anxiety disorders in adults". Cochrane Database of Systematic Reviews. 2016 (3): CD011565. doi:10.1002/14651858.cd011565.pub2. ISSN   1465-1858. PMC   7077612 . PMID   26968204.
  22. ↑ Bakker, David; Kazantzis, Nikolaos; Rickwood, Debra; Rickard, Nikki (2016-03-01). "Mental Health Smartphone Apps: Review and Evidence-Based Recommendations for Future Developments". JMIR Mental Health. 3 (1): e7. doi: 10.2196/mental.4984 . PMC   4795320 . PMID   26932350.
  23. ↑ Owen, Jason E.; Kuhn, Eric; Jaworski, Beth K.; McGee-Vincent, Pearl; Juhasz, Katherine; Hoffman, Julia E.; Rosen, Craig (2018-07-26). "VA mobile apps for PTSD and related problems: public health resources for veterans and those who care for them". mHealth. 4: 28. doi: 10.21037/mhealth.2018.05.07 . PMC   6087876 . PMID   30148141.
  24. ↑ Ameringen, Michael Van; Turna, Jasmine; Khalesi, Zahra; Pullia, Katrina; Patterson, Beth (2017). "There is an app for that! The current state of mobile applications (apps) for DSM-5 obsessive-compulsive disorder, posttraumatic stress disorder, anxiety and mood disorders". Depression and Anxiety. 34 (6): 526–539. doi: 10.1002/da.22657 . PMID   28569409. S2CID   205737534.
  25. ↑ Miner, Adam; Kuhn, Eric; Hoffman, Julia E.; Owen, Jason E.; Ruzek, Josef I.; Taylor, C. Barr (2016). "Feasibility, acceptability, and potential efficacy of the PTSD Coach app: A pilot randomized controlled trial with community trauma survivors". Psychological Trauma: Theory, Research, Practice, and Policy. 8 (3): 384–392. doi:10.1037/tra0000092. PMID   27046668.
  26. ↑ Sander, Lasse Bosse; Schorndanner, Johanna; Terhorst, Yannik; Spanhel, Kerstin; Pryss, Rüdiger; Baumeister, Harald; Messner, Eva-Maria (2020). "'Help for trauma from the app stores?' A systematic review and standardised rating of apps for Post-Traumatic Stress Disorder (PTSD)". European Journal of Psychotraumatology. 11 (1): 1701788. doi:10.1080/20008198.2019.1701788. PMC   6968629 . PMID   32002136.
  27. 1 2 van der Meer, Christianne A. I.; Bakker, Anne; van Zuiden, Mirjam; Lok, Anja; Olff, Miranda (2020-12-31). "Help in hand after traumatic events: a randomized controlled trial in health care professionals on the efficacy, usability, and user satisfaction of a self-help app to reduce trauma-related symptoms". European Journal of Psychotraumatology. 11 (1): 1717155. doi:10.1080/20008198.2020.1717155. PMC   7144205 . PMID   32284818.
  28. 1 2 Banbury, Annie; Nancarrow, Susan; Dart, Jared; Gray, Leonard; Parkinson, Lynne (2018). "Telehealth Interventions Delivering Home-based Support Group Videoconferencing: Systematic Review". Journal of Medical Internet Research. 20 (2): e25. doi: 10.2196/jmir.8090 . PMC   5816261 . PMID   29396387.
  29. ↑ Gentry, Melanie T.; Lapid, Maria I.; Clark, Matthew M.; Rummans, Teresa A. (2018-05-22). "Evidence for telehealth group-based treatment: A systematic review". Journal of Telemedicine and Telecare. 25 (6): 327–342. doi:10.1177/1357633X18775855. PMID   29788807. S2CID   46898472.
  30. ↑ "Online Support Groups: Nuts & Bolts, Benefits, Limitations and Future Directions". www.counseling.org. Retrieved 2020-10-14.
  31. ↑ Winzelberg, Andrew J.; Classen, Catherine; Alpers, Georg W.; Roberts, Heidi; Koopman, Cheryl; Adams, Robert E.; Ernst, Heidemarie; Dev, Parvati; Taylor, C. Barr (2003). "Evaluation of an internet support group for women with primary breast cancer". Cancer. 97 (5): 1164–1173. doi: 10.1002/cncr.11174 . PMID   12599221. S2CID   21187729.
  32. ↑ Baumel, Amit; Schueller, Stephen M. (2016). "Adjusting an Available Online Peer Support Platform in a Program to Supplement the Treatment of Perinatal Depression and Anxiety". JMIR Mental Health. 3 (1): e11. doi: 10.2196/mental.5335 . PMC   4820657 . PMID   27001373.
  33. ↑ Rebedew, David (2018). "Five Mobile Apps to Help Patients With Anxiety and Depression". Family Practice Management. 25 (2): 1–4.
  34. ↑ Treatment (US), Center for Substance Abuse (2014). Trauma Resource List. Substance Abuse and Mental Health Services Administration (US).
  35. ↑ "ISTSS - International Society for Traumatic Stress Studies". istss.org. Retrieved 2020-11-17.
  36. ↑ "Home - ClinicalTrials.gov". www.clinicaltrials.gov. Retrieved 2020-11-17.
  37. ↑ Wild, Jennifer; Warnock-Parkes, Emma; Grey, Nick; Stott, Richard; Wiedemann, Milan; Canvin, Lauren; Rankin, Harriet; Shepherd, Emma; Forkert, Ava; Clark, David M.; Ehlers, Anke (2016-11-08). "Internet-delivered cognitive therapy for PTSD: a development pilot series". European Journal of Psychotraumatology. 7: 31019. doi:10.3402/ejpt.v7.31019. PMC   5106866 . PMID   27837579.
  38. ↑ Marotta-Walters, Sylvia A.; Jain, Kshipra; DiNardo, Jeffrey; Kaur, Paramjit; Kaligounder, Shobila (2018-01-01). "A Review of Mobile Applications for Facilitating EMDR Treatment of Complex Trauma and Its Comorbidities". Journal of EMDR Practice and Research. 12 (1): 2–15. doi: 10.1891/1933-3196.12.1.2 . S2CID   149032907.
  39. ↑ Owen, Jason E.; Kuhn, Eric; Jaworski, Beth K.; McGee-Vincent, Pearl; Juhasz, Katherine; Hoffman, Julia E.; Rosen, Craig (2018). "VA mobile apps for PTSD and related problems: public health resources for veterans and those who care for them". mHealth. 4: 28. doi: 10.21037/mhealth.2018.05.07 . PMC   6087876 . PMID   30148141.
  40. ↑ Mouthaan, Joanne; Sijbrandij, Marit; de Vries, Giel-Jan; Reitsma, Johannes B; van de Schoot, Rens; Goslings, J Carel; Luitse, Jan SK; Bakker, Fred C; Gersons, Berthold PR; Olff, Miranda (2013). "Internet-Based Early Intervention to Prevent Posttraumatic Stress Disorder in Injury Patients: Randomized Controlled Trial". Journal of Medical Internet Research. 15 (8): e165. doi: 10.2196/jmir.2460 . PMC   3742408 . PMID   23942480.
  41. ↑ Zero, Odette; Geary, Meghan (2020-06-01). "COVID-19 and Intimate Partner Violence: A Call to Action". Rhode Island Medical Journal (2013). 103 (5): 57–59. PMID   32481784.
  42. 1 2 3 Zhai, Yusen (2020-06-04). "A Call for Addressing Barriers to Telemedicine: Health Disparities during the COVID-19 Pandemic". Psychotherapy and Psychosomatics. 90 (1): 64–66. doi:10.1159/000509000. ISSN   0033-3190. PMC   7316653 . PMID   32498070.
  43. ↑ Young, Calvin; Campbell, Kaitryn (2018). Internet-Delivered Cognitive Behavioral Therapy for Post-Traumatic Stress Disorder: A Review of Clinical Effectiveness. CADTH Rapid Response Reports. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health. PMID   30896898.
  44. ↑ Litvin, Silja; Saunders, Rob; Maier, Markus A.; Lüttke, Stefan (2020). "Gamification as an approach to improve resilience and reduce attrition in mobile mental health interventions: A randomized controlled trial". PLOS ONE. 15 (9): e0237220. Bibcode:2020PLoSO..1537220L. doi: 10.1371/journal.pone.0237220 . PMC   7467300 . PMID   32877425.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.