Improving the steps toward better, cost-effective PTSD treatment
Post-traumatic stress disorder (PTSD) is estimated to affect 3.9% of the global population, and stepped care can improve access to PTSD treatments by matching clients to a treatment type that best suits their needs. However, there is a lack of consensus about what treatments should be used, the criteria for stepping clients up to a higher-intensity treatment and who should start with…
Post-traumatic stress disorder (PTSD) impacts approximately 3.9% of the global populace. Stepped care provides a method to deliver PTSD treatments that align with each individual's requirements. Nonetheless, there remains uncertainty regarding the treatments to be used, the criteria for advancing to more intensive therapies, and who should commence with higher-intensity treatments.
To tackle this issue and offer guidance for clinical decision-making, researchers from Flinders University conducted a trial of an online stepped care approach for PTSD and published their findings in the journal Behaviour Research and Therapy.
The research, led by Dr. Larissa Roberts from Flinders College of Human Sciences and Culture, compared an online stepped care approach consisting of two treatment phases—This Way Up, an online self-guided therapy, and cognitive processing therapy (CPT), a conventional therapy—to CPT administered via telehealth among 84 adults diagnosed with PTSD or subthreshold PTSD.
The stepped care method was contrasted with CPT delivered through telehealth, involving 84 adults with PTSD or subthreshold PTSD. The stepped care treatment proved to be 8%–10% less costly to administer than CPT, while still achieving comparable improvements on the clinician-rated PTSD scale and in depression levels across all time points throughout the treatment program.
However, CPT exhibited a lower dropout rate (26% compared to 43%) and superior self-reported PTSD outcomes than the stepped care method. Despite this, both groups exhibited meaningful improvements in PTSD, depression, and quality of life during treatment and at a six-month follow-up. Dr. Roberts and co-researcher Professor Reg Nixon from Flinders University noted that the lower cost of the stepped care approach, coupled with its online delivery, holds the potential to enhance the accessibility of PTSD treatments for clients.
Further research is necessary to refine the stepped care approach, aiming to minimize dropout rates and optimize treatment outcomes for individuals seeking assistance for PTSD, as well as to determine which clients would benefit from initiating with low-intensity therapies.
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