ABSTRACT

Background: The use of remotely delivered early intervention after trauma may prevent and/or reduce symptoms of post-traumatic stress. Our research group evaluated a novel three-week therapist-guided internet-delivered intervention based on prolonged exposure (Condensed Internet-Delivered Prolonged Exposure; CIPE) in a pilot trial. The results indicated that the intervention was feasible, acceptable and reduced symptoms of post-traumatic stress at post-intervention compared to a waiting-list condition. Exposure to traumatic memories can be emotionally demanding and there is a need for detailed investigation of participants’ experiences in receiving this type of intervention remotely.

Objective: Investigate participants’ experiences of receiving CIPE early after trauma.

Method: In this study, qualitative thematic analysis was used and semi-structured interviews with 11 participants six months after intervention completion were conducted. All interviews were audio-recorded and transcribed verbatim.

Results: One overarching theme labelled as ‘demanding and effective’ was identified. Participants expressed that treatment effects could only be achieved by putting in a lot of effort and by being emotionally close to the trauma memory during exposure exercises. Participants reported CIPE to be a highly credible- and educative intervention that motivated them to fully engage in exposure exercises. The most distressing parts of the intervention was perceived as tolerable and important to do to heal psychologically after trauma. For many participants, the possibility to engage in the intervention whenever and where it suited them was helpful, although some participants described it as challenging to find a balance between their own responsibility and when to expect therapist support. The internet-based format was perceived as a safe forum for self-disclosure that helped some participants overcome avoidance due to shame during imaginal exposure.

Conclusion: CIPE was considered demanding, yet effective by the interviewed participants. The most distressing parts of the intervention was perceived to be the most important and were tolerable and feasible to provide online.

摘要

背景：在创伤后使用远程交付的早期干预可以预防和/或减少创伤后压力的症状。我们的研究小组在一项试验性试验中评估了一种基于长时间接触（Condensed Internet-Delivered Prolonged Exposure；CIPE）的新型为期三周的治疗师指导的互联网提供的干预措施。结果表明，与等候名单条件相比，干预是可行的、可接受的，并且在干预后减少了创伤后应激症状。暴露于创伤性记忆中可能对情绪要求很高，因此需要详细调查参与者在远程接受此类干预方面的经历。

目的：调查参与者在创伤后早期接受 CIPE 的经历。

方法：在这项研究中，使用定性主题分析，并在干预完成六个月后对 11 名参与者进行半结构化访谈。所有访谈均被录音并逐字转录。

结果：确定了一个标有“要求高且有效”的总体主题。参与者表示，只有付出大量的努力，并在暴露练习中在情感上接近创伤记忆，才能达到治疗效果。参与者报告 CIPE 是一种高度可信且具有教育意义的干预措施，促使他们充分参与接触练习。干预中最令人痛苦的部分被认为是可以容忍的，并且对于创伤后的心理治愈很重要。对于许多参与者来说，能够在适合他们的时间和地点参与干预是有帮助的，尽管一些参与者认为在他们自己的责任和何时期望治疗师支持之间找到平衡是一项挑战。

结论：受访者认为 CIPE 要求很高，但很有效。干预中最令人痛苦的部分被认为是最重要的，并且在线提供是可以容忍和可行的。