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Behavior Modification
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Therapist Adherence and Competence With Manualized Cognitive-Behavioral Therapy for PTSD Delivered via Videoconferencing Technology

B. Christopher Frueh

University of Hawai'i at Hilo, frueh{at}hawaii.edu

Jeannine Monnier

Medical University of South Carolina, Charleston

Anouk L. Grubaugh

Medical University of South Carolina, Charleston Veterans Affairs Medical Center, Charleston

Jon D. Elhai

Disaster Mental Health Institute, University of South Dakota, Vermillion

Eunsil Yim

Medical University of South Carolina, Charleston

Rebecca Knapp

Medical University of South Carolina, Charleston

Using secondary analyses from a randomized trial comparing the effectiveness of manualized cognitive-behavioral therapy for posttraumatic stress disorder, we compared ratings of therapist competency and adherence between two service delivery modes: telepsychiatry (TP) and same room (SR). Patients were 38 male treatment-seeking veterans recruited from a veterans affairs medical center. Domains of therapist competence and adherence included structuring sessions, implementing session activities, providing feedback, dealing with difficulties, developing rapport, and conveying empathy. Only one difference emerged between the two treatment conditions, with more favorable ratings on this item in the TP condition. Findings suggest that therapist competence and adherence to cognitive-behavioral therapy is similar whether the treatment is delivered via TP or by traditional means, and TP does not compromise therapists' ability to effectively structure sessions or build rapport with patients. These data further support the use of TP to address shortages in access to mental health care.

Key Words: PTSD • cognitive-behavioral therapy • therapist adherence • therapist competence • telepsychiatry • telemental health • rural mental health • veterans • empathy

Behavior Modification, Vol. 31, No. 6, 856-866 (2007)
DOI: 10.1177/0145445507302125
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