Why was the study done?
Groups like the military and public safety personnel (PSP) are regularly exposed to high levels of stress and potentially psychologically traumatic events (PPTE). The recent COVID-19 pandemic has highlighted the need for effective digital mental health treatment options.
The current academic review aimed to answer many of the questions surrounding digital mental healthcare options such as:
- What are the barriers and facilitators for people to use online services?
- How does digital mental healthcare compare to traditional face-to-face?
- Do we have enough quality academic literature to answer these questions?
What was done in the study?
Journal articles that address digitally delivered programs for military members, veterans, and PSP who had been diagnosed with PTSD were reviewed. The studies were limited to those that provided remote, i.e. person-to-person treatment (video, text, app-based, VR, and telephone). The review identified 629 articles. Duplicates and studies that did not match the criteria were removed through a process of abstract, and later, full-text review. The process left 38 studies that were reviewed.
What did we find out?
- The randomized control studies (a study were people were randomly assigned to a treatment or control group) reviewed were rated as fair to excellent quality. Qualitative studies reviewed were rated as valuable and contributed to the overall evidence on the topic.
- Studies showed that digitally offered treatment was effective at treating PTSD. There is good evidence that the digital options work just as well as in-person delivery.
- There was no difference in adherence to the programs or dropout rates.
- The review identified several facilitators: easy access, reduced stigma, lower cost, and better security and privacy, and comfort of the home environment.
- Several barriers were identified, such as tech issues, connectivity to internet, lack of a quiet place for the session, discomfort with being on camera, distraction, and safety (i.e. suicide risk).
Where do we go from here?
While the COVID-19 pandemic forced the rapid switch to more digital options, online therapy has been an area of growth for many years. Digital health options offer broad access to treatment, and with evidence that they are just as effective as in-person treatment, can provide a pathway for people seeking treatment. The increased use of these treatments during the pandemic has highlighted the many possible benefits of these digitally offered treatments. The expanded implementation of these types of programs should continue to be explored.
The original wording of the study was changed and condensed for the current research summary.
Jones, C., Miguel-Cruz, A. Smith-MacDonald, L., Cruikshank, E., Baghoori, D. Chohan, A.K., Laidlaw, A. White, A., Cao, B., Agyapong, V., Burback, L., Winkler, O., Sevigny, P.R., Dennet, L., Ferguson-Pell, M., Greenshaw, A., & Bremault-Phillips, S. (2020). Virtual trauma-focused therapy for military members, veterans, and public safety personnel with posttraumatic stress injury: Systematic scoping review. JMIR Mhealth Uhealth. https://mhealth.jmir.org/2020/9/e22079/
Summary prepared by Kossick, E. Edited & reviewed by Barootes, B. and Jones, C.