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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

References

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  • Committee on the Future of Rural Health Care, Institute of Medicine. (2004). Quality through collaboration: The future of rural health care. Washington, DC: National Academies Press.
  • Frueh, B.C., Deitsch, S.E., Santos, A.B., Gold P.B., Johnson, M.R., Meisler, N., Magruder, K.M., & Ballenger, J.C. (2000). Procedural and methodological issues in telepsychiatry research and program development. Psychiatric Services, 51, 1522-1527.[Abstract/Free Full Text]
  • Frueh, B.C., Monnier, J., Yim, E., Grubaugh, A.L., Hamner, M.B., & Knapp, R.G. (2007). A randomized trial of telepsychiatry for post-traumatic stress disorder. Journal of Telemedicine and Telecare, 13, 142-147.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Frueh, B.C., Turner, S.M., Beidel, D.C., Mirabella, R.F., & Jones, W.J. (1996). Trauma Management Therapy: A preliminary evaluation of a multicomponent behavioral treatment for chronic combat-related PTSD. Behaviour Research and Therapy, 34, 533-543.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Hilty, D.M., Marks, S.L., Urness, D., Yellowlees, P.M., & Nesbitt, T.S. (2004). Clinical and education telepsychiatry applications: A review. Canadian Journal of Psychiatry, 49, 12-23.[Medline] [Order article via Infotrieve]
  • Monnier, J., Knapp, R.G., Frueh, B.C. (2003). Recent advances in telepsychiatry: An updated review. Psychiatric Services, 54, 1604-1609.[Abstract/Free Full Text]
  • New Freedom Commission on Mental Health. ( 2003). Achieving the promise: Transforming mental health care in America. Washington, DC: Author.
  • Turner, S.M., Beidel, D.C., Cooley, M.R., Woody, S.R., & Messer, S.C. (1994). A multicomponent behavioral treatment for social phobia: Social Effectiveness Therapy. Behaviour Research Therapy, 32, 381-390.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Turner, S.M., Frueh, B.C., & Beidel, D.C. (2005). Multicomponent behavioral treatment for chronic combat-related posttraumatic stress disorder: Trauma Management Therapy. Behavior Modification, 29, 39-69.[Abstract/Free Full Text]

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


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This Article
Right arrow Abstract Freely available
Right arrow Free Full Text (Free PDF) Free
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via Web of Science (1)
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Frueh, B. C.
Right arrow Articles by Knapp, R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Frueh, B. C.
Right arrow Articles by Knapp, R.
Right arrowPubmed/NCBI databases
Medline Plus Health Information
*Post-Traumatic Stress Disorder
Social Bookmarking
 Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?