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Online Structured Writing Therapy for Post-traumatic Stress Disorder and Complicated Grief

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Guided Internet-Based Treatments in Psychiatry

Abstract

Post-traumatic stress disorder (PTSD) and complicated grief are related disorders for which well-described and effective cognitive-behavioural therapeutic procedures exist that are firmly rooted in theoretical work. As a result, several research groups have been able to successfully translate these procedures into e-mental health applications for the prevention, detection and treatment of the disorders. This chapter reviews online structured writing therapy (oSWT), a standardised therapist-guided Internet-based cognitive-behavioural treatment (ICBT) for post-traumatic stress disorder and complicated grief, which can be fully delivered online, without face-to-face contact between the patient and therapist. This protocol integrates three principal elements of trauma-focused therapy: (1) exposure through self-confrontation, (2) cognitive reappraisal and (3) strengthening of social support. A unique characteristic of oSWT is that it implements these three elements through writing assignments. In the past two decades, oSWT has been validated in a series of controlled studies and in routine clinical practice, with positive results. This chapter reviews these efficacy and effectiveness trials, elaborates on the details of the therapeutic procedures of the treatment protocol and identifies future research themes.

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Notes

  1. 1.

    In this uncontrolled study, d</Emphasis> was calculated as the standardized mean pre-post within-group change score, using the pretest standard deviation as the standardizer. Note that these effect sizes cannot be directly compared to the between-group effect sizes of the comparative studies (which represent the standardized difference between the pre-post change scores in the experimental groups).

Abbreviations

BSI:

Brief symptom inventory

DASS:

Depression anxiety stress scale

ICBT:

Internet-based cognitive behaviour therapy

IES:

Impact of event scale

LIWC:

Linguistic inquiry and word count

oSWT:

Online structured writing therapy

PTSD:

Post-traumatic stress disorder

SWT:

Structured writing therapy

WAI:

Working alliance inventory

WLC:

Waiting-list/delayed treatment condition

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Acknowledgements and Disclosure of Conflict of Interest

The authors would like to acknowledge Bart Schrieken of Interapy PLC, for his valuable contributions. At present, both authors have no financial ties to this company.

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Ruwaard, J., Lange, A. (2016). Online Structured Writing Therapy for Post-traumatic Stress Disorder and Complicated Grief. In: Lindefors, N., Andersson, G. (eds) Guided Internet-Based Treatments in Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-319-06083-5_7

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