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

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