Combat Stress, Surrey, UK.
J Telemed Telecare. 2018 Oct;24(9):575-585. doi: 10.1177/1357633X17730443. Epub 2017 Sep 29.
Introduction Despite increases in the number of ex-service personnel seeking treatment for post-traumatic stress disorder (PTSD), there remain a number of barriers to help-seeking which prevents many veterans from accessing psychological therapies. Tele-therapy provides one potential method of increasing the number of veterans accessing support. This review aimed to systematically review the literature in order to summarise what lessons have been learned so far from providing trauma-focused tele-therapies to veterans with PTSD. Methods A systematic literature review was conducted from which 41 papers were reviewed. Studies were included if they involved the use of trauma-focused therapies carried out using tele-therapy technologies. Only studies using tele-therapy interventions via video or telephone with populations of ex-military personnel with PTSD were included. Results In the majority of cases tele-therapy was found to be as effective in reducing PTSD symptoms as in-person interventions. Similarly, there were few differences in most process outcomes such as dropout rates, with tele-therapy helping to increase uptake in some cases. Veterans using tele-therapy reported high levels of acceptability and satisfaction. Some challenges were reported in terms of therapeutic alliance, with some studies suggesting that veterans felt less comfortable in using tele-therapy. Several studies suggested it was harder for clinicians to read non-verbal communication in tele-therapy, but this did not affect their ability to build rapport. Technological issues were encountered, but these were not found to impede therapy processes or outcomes. Discussion Tele-therapy provides a viable alternative to in-person therapies and has the potential to increase access to therapy for veterans. Tele-therapy should continue to be evaluated and scrutinised in order to establish the most effective methods of delivery.
简介 尽管寻求创伤后应激障碍（PTSD）治疗的退役军人人数有所增加，但仍存在许多寻求帮助的障碍，这使得许多退伍军人无法获得心理治疗。远程治疗提供了一种增加接触支持的退伍军人数量的潜在方法。本综述旨在系统地回顾文献，总结迄今为止从为 PTSD 退伍军人提供以创伤为中心的远程治疗中学到的经验教训。 方法 进行了系统的文献综述，共审查了 41 篇论文。如果研究涉及使用远程治疗技术进行以创伤为中心的治疗，则纳入研究。仅纳入使用视频或电话进行远程治疗干预，且干预对象为 PTSD 退伍军人的军事人员的研究。 结果 在大多数情况下，远程治疗在减少 PTSD 症状方面与面对面干预同样有效。同样，在大多数过程结果（如辍学率）方面，远程治疗也很少有差异，在某些情况下，远程治疗有助于增加参与度。使用远程治疗的退伍军人报告了较高的可接受性和满意度。一些研究报告了治疗联盟方面的挑战，一些退伍军人认为使用远程治疗不太舒服。一些研究表明，远程治疗中临床医生更难阅读非言语交流，但这并不影响他们建立融洽关系的能力。遇到了技术问题，但这些问题并未影响治疗过程或结果。 讨论 远程治疗为面对面治疗提供了一种可行的替代方法，并有潜力增加退伍军人获得治疗的机会。应继续评估和审查远程治疗，以确定最有效的治疗方法。
