ABSTRACT

Background: Home-based psychotherapy delivered via telehealth has not been investigated in the context of intensive trauma-focused treatment for individuals with severe or Complex posttraumatic stress disorder (PTSD).

Objective: To examine the feasibility, safety and effectiveness of an intensive treatment programme containing prolonged exposure, EMDR therapy, physical activities and psycho-education, delivered via home-based telehealth.

Method: The treatment was carried out within four consecutive days during the outbreak of the COVID-19 pandemic. The sample consisted of six (four female) patients suffering from severe or Complex PTSD resulting from exposure to multiple traumatic events, mostly during early childhood. Four of them fulfilled the diagnostic criteria of complex PTSD. Outcome measures were the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), the PTSD Checklist for DSM-5 (PCL-5), and the International Trauma Questionnaire (ITQ).

Results: CAPS-5 and PCL-5 scores decreased significantly from pre- to post-treatment (Cohen’s ds 1.04 and 0.93), and from post-treatment to follow-up (Cohen’s ds 0.92 and 1.24). Four of the six patients lost their PTSD or Complex PTSD diagnostic status. No patient dropped out, no personal adverse events and no reliable symptom worsening occurred.

Conclusions: The results suggest that intensive, trauma-focused treatment of severe or Complex PTSD delivered via home-based telehealth is feasible, safe and effective, and can be a viable alternative to face-to-face delivered intensive trauma-focused treatment.

摘要

背景：在针对严重或复杂创伤后应激障碍 (PTSD) 患者的以创伤为中心的强化治疗背景下，尚未研究通过远程医疗提供的家庭心理治疗。

目的：检查通过家庭远程医疗提供的强化治疗计划的可行性、安全性和有效性，该计划包括长时间暴露、EMDR 治疗、体育活动和心理教育。

方法：治疗是在 COVID-19 大流行爆发期间的连续四天内进行的。该样本由六名（四名女性）患者组成，他们因接触多种创伤事件而患有严重或复杂的 PTSD，这些事件主要发生在幼儿期。其中四人符合复杂PTSD的诊断标准。结果测量是 DSM-5 的临床医生管理的 PTSD 量表 (CAPS-5)、DSM-5 的 PTSD 检查表 (PCL-5) 和国际创伤问卷 (ITQ)。

结果：CAPS-5 和 PCL-5 评分从治疗前到治疗后（Cohen's d s 1.04 和 0.93）以及从治疗后到随访（Cohen's d s 0.92 和 1.24）显着下降。六名患者中有四名失去了他们的 PTSD 或复杂 PTSD 诊断状态。没有患者退出，没有个人不良事件，也没有可靠的症状恶化发生。

结论：结果表明，通过以家庭为基础的远程医疗对严重或复杂的 PTSD 进行密集的、以创伤为中心的治疗是可行、安全和有效的，并且可以成为面对面提供的以创伤为中心的强化治疗的可行替代方案。