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

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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.

Keywords

Bereavement Cognitive behaviour therapy Computer-assisted therapy Post-traumatic stress disorders therapy Structured writing assignments Trauma and stressor-related disorders Internet Treatment protocol 

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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Notes

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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© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of Clinical, Neuro, and Developmental PsychologyVrije Universiteit AmsterdamAmsterdamThe Netherlands
  2. 2.Department of Clinical PsychologyUniversiteit van AmsterdamAmsterdamThe Netherlands

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