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Review
. 2022 Oct;39(10-11):675-685.
doi: 10.1002/da.23272. Epub 2022 May 27.

Trauma-focused guided self-help interventions for posttraumatic stress disorder: A meta-analysis of randomized controlled trials

Andy P Siddaway  1 , Richard Meiser-Stedman  2 , Verity Chester  3 , Jack Finn  2 , Cliodhna O Leary  2 , David Peck  2 , Camilla Loveridge  2
Affiliations
Review

Trauma-focused guided self-help interventions for posttraumatic stress disorder: A meta-analysis of randomized controlled trials

Andy P Siddaway et al. Depress Anxiety. 2022 Oct.

Abstract

Trauma-focused guided self-help (TF-GSH) is an important alternative to psychological therapy delivered by a therapist. This meta-analysis evaluates the efficacy of TF-GSH in reducing posttraumatic stress disorder (PTSD) symptoms and comorbid depressive and anxiety symptoms. A total of 17 trials were included that compared a TF-GSH intervention (N = 610) to various control comparators (N = 570). Control conditions included treatment as usual (k = 2), waiting list (k = 11), phone monitoring (k = 1), nontrauma writing (k = 1), general support (k = 1), and supportive counseling (k = 1). A moderate- to large-sized effect favouring TF-GSH was observed for PTSD (k = 17, g = -0.81, 95% confidence interval [CI]: -1.24, -0.39) and a moderate-sized effect was observed for depressive (k = 13, g = -0.73, 95% CI: -1.16, -0.31) and anxiety (k = 11, g = -0.72, 95% CI: -1.18, -0.27) symptoms, with considerable heterogeneity. Moderator analyses were all not statistically significant. Results indicate that TF-GSH is a promising treatment for PTSD and comorbid depressive and anxiety symptoms. We discuss the nature, extent, and quality of the literature to provide a point of departure for future research. TF-GSH (and unguided self-help) may not be appropriate for certain individuals at certain times. Exploring a broad range of treatment delivery modalities will move the field closer towards a model of evidence-based care in which the likely appropriate dose and type of intervention can be matched to individuals based on presenting problems and other variables.

Keywords: cognitive-behavioral; effectiveness; efficacy; posttraumatic stress disorder; review; self-help; therapy.

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Figures

Figure 1
Figure 1
Preferred reporting items for systematic reviews and meta‐analysis flow chart of study selection process
Figure 2
Figure 2
Forest plots of effect sizes for PTSD, depressive symptoms, and anxiety symptoms. PTSD, posttraumatic stress disorder
See this image and copyright information in PMC

References

    1. References marked with an asterisk indicate studies included in the meta‐analysis.
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    1. Bryant, R. (2019). Post‐traumatic stress disorder: A state‐of‐the‐art review of evidence and challenges. World Psychiatry: Official Journal of the World Psychiatric Association, 18, 259–269. - PMC - PubMed

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