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Guided Internet-Based Treatments in Psychiatry pp 121–141Cite as

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

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

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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

References

  • Amstadter AB, Broman-Fulks J, Zinzow H, Ruggiero KJ, Cercone J (2009) Internet-based interventions for traumatic stress-related mental health problems: a review and suggestion for future research. Clin Psychol Rev 29(5):410–420. doi:10.1016/j.cpr.2009.04.001

    CrossRef  PubMed  PubMed Central  Google Scholar 

  • Andersson G (2010) Guided, internet-delivered cognitive behavioral therapy for posttraumatic stress disorder and other comorbid anxiety disorders. In: Brunet A, Ashbaugh AR, Herbert CF (eds) NATO science for peace and security series – E: human and societal dynamics, vol 72, Internet use in the aftermath of trauma. IOS Press, Amsterdam, pp 243–254, Retrieved from http://ebooks.iospress.nl/publication/25291

    Google Scholar 

  • Arrindell WA, Ettema JHM (2003) Symptom checklist SCL-90: Handleiding bij een multidimensionele psychopathologie-indicator. Swets Test Publishers; Harcourt Test Publishers, Lisse/Amsterdam

    Google Scholar 

  • Benight CC, Ruzek JI, Waldrep E (2008) Internet interventions for traumatic stress: a review and theoretically based example. J Trauma Stress 21(6):513–520. doi:10.1002/jts.20371

    CrossRef  PubMed  Google Scholar 

  • Boelen PA, van den Hout MA (2008) The role of threatening misinterpretations and avoidance in emotional problems after loss. Behav Cogn Psychother 36(01):71–88. doi:10.1017/S1352465807004079

    CrossRef  Google Scholar 

  • Brewin CR, Holmes EA (2003) Psychological theories of posttraumatic stress disorder. Clin Psychol Rev 23(3):339–376. doi:10.1016/S0272-7358(03)00033-3

    CrossRef  PubMed  Google Scholar 

  • Brewin CR, Andrews B, Valentine JD (2000) Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. J Consult Clin Psychol 68(5):748–766. doi:10.1037//0022-006X.68.5.748

    CrossRef  CAS  PubMed  Google Scholar 

  • Brunet A, Ashbaugh AR, Herbert CF (eds) (2010) NATO science for peace and security series – E: human and societal dynamics, vol 72, Internet use in the aftermath of trauma. IOS Press, Amsterdam

    Google Scholar 

  • Cuijpers P, Marks IM, Van Straten A, Cavanagh K, Gega L, Andersson G (2009) Computer-aided psychotherapy for anxiety disorders: a meta-analytic review. Cogn Behav Ther 38(2):66–82. doi:10.1080/16506070802694776

    CrossRef  PubMed  Google Scholar 

  • De Haas S, Höing M, Schrieken B, Tsagana A, Wijnker C, Michels C, Lange A (2009) Behandeling via het Internet voor jeugdige slachtoffers van seksueel geweld: een pilotstudie [Online treatment of young victims of sexual violence: a pilot study]. Maandblad Geestelijke Volksgezondheid 64(11):981–997

    Google Scholar 

  • Derogatis LR, Melisaratos N (1983) The Brief Symptom Inventory: an introductory report. Psychol Med 13(3):595–605

    CrossRef  CAS  PubMed  Google Scholar 

  • Donnelly DA, Murray EJ (1991) Cognitive and emotional changes in written essays and therapy interviews. J Soc Clin Psychol 10(3):334–350. doi:10.1521/jscp.1991.10.3.334

    CrossRef  Google Scholar 

  • Ehlers A, Clark DM (2000) A cognitive model of posttraumatic stress disorder. Behav Res Ther 38(4):319–345. doi:10.1016/S0005-7967(99)00123-0

    CrossRef  CAS  PubMed  Google Scholar 

  • Foa EB, Kozak MJ (1986) Emotional processing of fear: exposure to corrective information. Psychol Bull 99(1):20–35. doi:10.1037/0033-2909.99.1.20

    CrossRef  CAS  PubMed  Google Scholar 

  • Frank JD (1973) Persuasion and healing. John Hopkins University Press, Baltimore

    Google Scholar 

  • Haley J (1973) Uncommon therapy: the psychiatric techniques of Milton H. Erickson. MD. Norton, New York

    Google Scholar 

  • Harvey AG, Bryant RA, Tarrier N (2003) Cognitive behaviour therapy for posttraumatic stress disorder. Clin Psychol Rev 23(3):501–522

    CrossRef  PubMed  Google Scholar 

  • Hirai M, Clum GA (2005) An Internet-based self-change program for traumatic event related fear, distress, and maladaptive coping. J Trauma Stress 18(6):631–636. doi:10.1002/jts.20071

    CrossRef  PubMed  Google Scholar 

  • Hirai M, Skidmore ST, Clum GA, Dolma S (2012) An investigation of the efficacy of online expressive writing for trauma-related psychological distress in Hispanic individuals. Behav Ther 43(4):812–824. doi:10.1016/j.beth.2012.04.006

    CrossRef  PubMed  Google Scholar 

  • Horvath AO, Greenberg LS (1989) Development and validation of the Working Alliance Inventory. J Couns Psychol 36(2):223–233. doi:10.1037/0022-0167.36.2.223

    CrossRef  Google Scholar 

  • Ivarsson D, Blom M, Hesser H, Carlbring P, Enderby P, Nordberg R, Andersson G (2014) Guided internet-delivered cognitive behavior therapy for post-traumatic stress disorder: a randomized controlled trial. Internet Interv 1(1):33–40. doi:10.1016/j.invent.2014.03.002

    CrossRef  Google Scholar 

  • Jacobson NS, Truax P (1991) Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. J Consult Clin Psychol 59(1):12–19. doi:10.1037/0022-006X.59.1.12

    CrossRef  CAS  PubMed  Google Scholar 

  • Joseph S (2000) Psychometric evaluation of Horowitz’s Impact of Event Scale: a review. J Trauma Stress 13(1):101–113. doi:10.1023/A:1007777032063

    CrossRef  CAS  PubMed  Google Scholar 

  • Kersting A, Dölemeyer R, Steinig J, Walter F, Kroker K, Baust K, Wagner B (2013) Brief Internet-based intervention reduces posttraumatic stress and prolonged grief in parents after the loss of a child during pregnancy: a randomized controlled trial. Psychother Psychosom 82(6):372–381. doi:10.1159/000348713

    CrossRef  PubMed  Google Scholar 

  • Klein B, Mitchell J, Abbott J, Shandley K, Austin D, Gilson K, Kiropoulos L, Cannard G, Redman T (2010) A therapist-assisted cognitive behavior therapy internet intervention for posttraumatic stress disorder: pre-, post- and 3-month follow-up results from an open trial. J Anxiety Disord 24(6):635–644. doi:10.1016/j.janxdis.2010.04.005

    CrossRef  PubMed  Google Scholar 

  • Knaevelsrud C, Maercker A (2006) Does the quality of the working alliance predict treatment outcome in online psychotherapy for traumatized patients? J Med Internet Res 8(4):e31. doi:10.2196/jmir.8.4.e31

    CrossRef  PubMed  PubMed Central  Google Scholar 

  • Knaevelsrud C, Maercker A (2007) Internet-based treatment for PTSD reduces distress and facilitates the development of a strong therapeutic alliance: a randomized controlled clinical trial. BMC Psychiatry 7:13. doi:10.1186/1471-244X-7-13

    CrossRef  PubMed  PubMed Central  Google Scholar 

  • Knaevelsrud C, Maercker A (2010) Long-term effects of an internet-based treatment for posttraumatic stress. Cogn Behav Ther 39(1):72–77. doi:10.1080/16506070902999935

    CrossRef  PubMed  Google Scholar 

  • Knaevelsrud C, Wagner B, Karl A, Mueller J (2007) New treatment approaches: integrating new media in the treatment of war and torture victims. Torture (Quarterly Journal on Rehabilitation of Torture Victims and Prevention of Torture) 17(2):67–78

    Google Scholar 

  • Knaevelsrud C, Brand J, Schulz W, Lange A, Ruwaard J, Wagner B (2015) Internet-based psychotherapy for posttraumatic stress disorder in war-traumatized Arab patients: a parallel group randomized controlled trial. J Med Internet Res 17(3):e71. doi:10.2196/jmir.3582

    CrossRef  PubMed  PubMed Central  Google Scholar 

  • Lange A (1985) Motivating clients in directive family therapy. In: Zeig JK (ed) Ericksonian psychotherapy, vol 2, Clinical applications. Brunner Mazel, New York

    Google Scholar 

  • Lange A (1994) Writing assignment in the treatment of grief and trauma’s from the past. In: Zeig JK (ed) Ericksonian methods. The essence of the story, 1st edn. Brunner/Mazel, Levittown.

    Google Scholar 

  • Lange A, Ruwaard J (2010) Ethical dilemmas in online research and treatment of sexually abused adolescents. J Med Internet Res 12(5):e58. doi:10.2196/jmir.1455

    CrossRef  PubMed  PubMed Central  Google Scholar 

  • Lange A, Van der Hart O (1983) Directive family therapy. Brunner/Mazel, New York

    Google Scholar 

  • Lange A, De Beurs E, Dolan C, Lachnit T, Sjollema S, Hanewald G (1999) Long-term effects of childhood sexual abuse: objective and subjective characteristics of the abuse and psychopathology in later life. J Nerv Ment Dis 187(3):150–158

    CrossRef  CAS  PubMed  Google Scholar 

  • Lange A, Van de Ven J, Schrieken B, Bredeweg B, Emmelkamp PM (2000a) Internet-mediated, protocol-driven treatment of psychological dysfunction. J Telemed Telecare 6(1):15–21. doi:10.1258/1357633001933880

    CrossRef  CAS  PubMed  Google Scholar 

  • Lange A, Van de Ven J, Schrieken B, Emmelkamp P, Bredeweg B, Van der Kolk J, Lydsdottir L, Massaro M, Reuvers A (2000b) ‘INTERAPY’: the effects of a short protocolled treatment of post-traumatic stress and pathological grief through the Internet. Behav Cogn Psychother 28(2):103–120

    Google Scholar 

  • Lange A, Van de Ven J, Schrieken B, Emmelkamp PM (2001) Interapy, treatment of posttraumatic stress through the Internet: a controlled trial. J Behav Ther Exp Psychiatry 32(2):73–90

    CrossRef  CAS  PubMed  Google Scholar 

  • Lange A, Schoutrop MJA, Schrieken B, Van de Ven J (2002) Interapy: a model for therapeutic writing through the internet. In: Lepore SJ, Smyth JM (eds) The writing cure. How expressive writing promotes health and emotional well-being, 1st edn. American Psychological Association, Washington, DC, pp 215–238

    CrossRef  Google Scholar 

  • Lange A, Rietdijk D, Hudcovicova M, Van de Ven J, Schrieken B, Emmelkamp PM (2003a) Interapy: a controlled randomized trial of the standardized treatment of posttraumatic stress through the internet. J Consult Clin Psychol 71(5):901–909. doi:10.1037/0022-006X.71.5.901

    CrossRef  PubMed  Google Scholar 

  • Lange A, Van de Ven J, Schrieken B (2003b) Interapy: treatment of post-traumatic stress via the internet. Cogn Behav Ther 32(3):110–124. doi:10.1080/16506070302317

    CrossRef  PubMed  Google Scholar 

  • Langner R, Maercker A (2005) Complicated grief as a stress response disorder: evaluating diagnostic criteria in a German sample. J Psychosom Res 58(3):235–242. doi:10.1016/j.jpsychores.2004.09.012

    CrossRef  PubMed  Google Scholar 

  • Laska KM, Gurman AS, Wampold BE (2013) Expanding the lens of evidence-based practice in psychotherapy: a common factors perspective. Psychotherapy (Chicago, IL). doi:10.1037/a0034332

    Google Scholar 

  • Lemmen A, Maas M (2001) Inhoudsanalyse van cognitieve categorieën in gestructureerde schrijfopdrachten via Interapy [Content analysis of structured writing.]. Department of Clinical Psychology

    Google Scholar 

  • Lepore SJ, Smyth JM (eds) (2002) The writing cure: how expressive writing promotes health and emotional well-being, 1st edn. American Psychological Association, Washington, DC

    Google Scholar 

  • Litz BT, Engel CC, Bryant RA, Papa A (2007) A randomized, controlled proof-of-concept trial of an Internet-based, therapist-assisted self-management treatment for posttraumatic stress disorder. Am J Psychiatry 164(11):1676–1683. doi:10.1176/appi.ajp.2007.06122057

    CrossRef  PubMed  Google Scholar 

  • Martin DJ, Garske JP, Davis MK (2000) Relation of the therapeutic alliance with outcome and other variables: a meta-analytic review. J Consult Clin Psychol 68(3):438–450. doi:10.1037/0022-006X.68.3.438

    CrossRef  CAS  PubMed  Google Scholar 

  • Messer SB, Wampold BE (2002) Let’s face facts: common factors are more potent than specific therapy ingredients. Clin Psychol Sci Pract 9(1):21–25. doi:10.1093/clipsy.9.1.21

    CrossRef  Google Scholar 

  • Moreau C, Zisook S (2002) Rationale for a posttraumatic stress spectrum disorder. Psychiatr Clin North Am 25(4):775–790

    CrossRef  PubMed  Google Scholar 

  • Motraghi TE, Seim RW, Meyer EC, Morissette SB (2014) Virtual reality exposure therapy for the treatment of posttraumatic stress disorder: a methodological review using CONSORT guidelines. J Clin Psychol 70(3):197–208. doi:10.1002/jclp.22051

    CrossRef  PubMed  Google Scholar 

  • Mouthaan J, Sijbrandij M, de Vries G-J, Reitsma JB, van de Schoot R, Goslings JC, Luitse JS, Bakker FC, Gersons BP, Olff M (2013) Internet-based early intervention to prevent posttraumatic stress disorder in injury patients: randomized controlled trial. J Med Internet Res 15(8):e165. doi:10.2196/jmir.2460

    CrossRef  PubMed  PubMed Central  Google Scholar 

  • Nelson RJ (2013) Is virtual reality exposure therapy effective for service members and veterans experiencing combat-related PTSD? Traumatology 19(3):171–178. doi:10.1177/1534765612459891

    CrossRef  Google Scholar 

  • Norcross JC, Wampold BE (2011) Evidence-based therapy relationships: research conclusions and clinical practices. Psychotherapy (Chicago, IL) 48(1):98–102. doi:10.1037/a0022161

    CrossRef  Google Scholar 

  • Pennebaker JW (1993) Putting stress into words: health, linguistic, and therapeutic implications. Behav Res Ther 31(6):539–548. doi:10.1016/0005-7967(93)90105-4

    CrossRef  CAS  PubMed  Google Scholar 

  • Pennebaker JW, Susman JR (1988) Disclosure of traumas and psychosomatic processes. Soc Sci Med 26(3):327–332. doi:10.1016/0277-9536(88)90397-8

    CrossRef  CAS  PubMed  Google Scholar 

  • Pennebaker JW, Booth RJ, Francis ME (2007) Operator’s manual Linguistic Inquiry and Word Count: LIWC2007. LIWC.net, Austin

    Google Scholar 

  • Possemato K, Ouimette P, Knowlton P (2011) A brief self-guided telehealth intervention for post-traumatic stress disorder in combat veterans: a pilot study. J Telemed Telecare 17(5):245–250. doi:10.1258/jtt.2011.100909

    CrossRef  PubMed  Google Scholar 

  • Ruggiero KJ, Resnick HS, Acierno R, Carpenter MJ, Kilpatrick DG, Coffey SF, Carpenter MJ, Ruscio AM, Stephens RS, Kilpatrick DG, Stasiewicz PR, Roffman RA, Bucuvalas M, Galea S (2006) Internet-based intervention for mental health and substance use problems in disaster-affected populations: a pilot feasibility study. Behav Ther 37(2):190–205. doi:10.1016/j.beth.2005.12.001

    CrossRef  PubMed  Google Scholar 

  • Ruwaard J (2009) Computerized text analysis in computer-mediated therapy: the Interapy post-traumatic stress corpus (presentation slides): Presented at the Fourth Meeting of the International Society for Research on Internet Interventions; 14–16 October [presentation slides]. Amsterdam. Retrieved from http://www.slideshare.net/jruwaard/text-analysis-of-the-interapy-pts-corpus

  • Ruwaard J (2012) The efficacy and effectiveness of online CBT. Department of Clinical Psychology, the University of Amsterdam, Amsterdam

    Google Scholar 

  • Ruwaard J, Lange A, Schrieken B, Dolan CV, Emmelkamp P (2012) The effectiveness of online cognitive behavioral treatment in routine clinical practice. PLoS One 7(7):e40089. doi:10.1371/journal.pone.0040089

    CrossRef  CAS  PubMed  PubMed Central  Google Scholar 

  • Schoutrop MJA, Lange A, Hanewald G, Davidovich U, Salomon H (2002) Structured writing and processing major stressful events: a controlled trial. Psychother Psychosom 71(3):151–157. doi:10.1159/000056282

    CrossRef  PubMed  Google Scholar 

  • Seitz DCM, Knaevelsrud C, Duran G, Waadt S, Loos S, Goldbeck L (2014) Efficacy of an internet-based cognitive-behavioral intervention for long-term survivors of pediatric cancer: a pilot study. Supportive Care Cancer (Official Journal of the Multinational Association of Supportive Care in Cancer) 22(8):2075–2083. doi:10.1007/s00520-014-2193-4

    CrossRef  Google Scholar 

  • Sloan DM, Marx BP (2004) Taking pen to hand: evaluating theories underlying the written disclosure paradigm. Clin Psychol Sci Pract 11(2):121–137. doi:10.1093/clipsy.bph062

    CrossRef  Google Scholar 

  • Spence J, Titov N, Dear BF, Johnston L, Solley K, Lorian C, Wootton B, Zou J, Schwenke G (2011) Randomized controlled trial of Internet-delivered cognitive behavioral therapy for posttraumatic stress disorder. Depress Anxiety 28(7):541–550. doi:10.1002/da.20835

    CrossRef  PubMed  Google Scholar 

  • Spence J, Titov N, Johnston L, Dear BF, Wootton B, Terides M, Zou J (2013) Internet-delivered eye movement desensitization and reprocessing (iEMDR): an open trial. F1000Research 2:79. doi:10.12688/f1000research.2-79.v2

    Google Scholar 

  • Steinmetz SE, Benight CC, Bishop SL, James LE (2012) My Disaster Recovery: a pilot randomized controlled trial of an Internet intervention. Anxiety Stress Coping 25(5):593–600. doi:10.1080/10615806.2011.604869

    CrossRef  PubMed  Google Scholar 

  • Sundin EC, Horowitz MJ (2003) Horowitz’s Impact of Event Scale evaluation of 20 years of use. Psychosom Med 65(5):870–876

    CrossRef  PubMed  Google Scholar 

  • Thompson RF (2009) Habituation: a history. Neurobiol Learn Mem 92(2):127–134. doi:10.1016/j.nlm.2008.07.011

    CrossRef  PubMed  Google Scholar 

  • Van der Oord S, Lucassen S, Van Emmerik AAP, Emmelkamp PMG (2010) Treatment of post-traumatic stress disorder in children using cognitive behavioural writing therapy. Clin Psychol Psychother 17(3):240–249. doi:10.1002/cpp.670

    PubMed  Google Scholar 

  • Van der Velden K (ed) (1977, 1980, 1989) Directieve therapie/1,2,3 [Directive Therapy]. Van Loghum Slaterus, Deventer

    Google Scholar 

  • Van Emmerik AAP, Kamphuis JH, Emmelkamp PMG (2008) Treating acute stress disorder and posttraumatic stress disorder with cognitive behavioral therapy or structured writing therapy: a randomized controlled trial. Psychother Psychosom 77(2):93–100. doi:10.1159/000112886

    CrossRef  PubMed  Google Scholar 

  • Van Emmerik AAP, Reijntjes A, Kamphuis JH (2013) Writing therapy for posttraumatic stress: a meta-analysis. Psychother Psychosom 82(2):82–88. doi:10.1159/000343131

    CrossRef  PubMed  Google Scholar 

  • Van Voorhees BW, Gollan J, Fogel J (2012) Pilot study of Internet-based early intervention for combat-related mental distress. J Rehabil Res Dev 49(8):1175–1190. doi:10.1682/JRRD.2011.05.0095

    CrossRef  PubMed  Google Scholar 

  • Wagner B, Maercker A (2007) A 1.5-year follow-up of an Internet-based intervention for complicated grief. J Trauma Stress 20(4):625–629. doi:10.1002/jts.20230

    CrossRef  PubMed  Google Scholar 

  • Wagner B, Knaevelsrud C, Maercker A (2006) Internet-based cognitive-behavioral therapy for complicated grief: a randomized controlled trial. Death Stud 30(5):429–453. doi:10.1080/07481180600614385

    CrossRef  PubMed  Google Scholar 

  • Wagner B, Brand J, Schulz W, Knaevelsrud C (2012a) Online working alliance predicts treatment outcome for posttraumatic stress symptoms in Arab war-traumatized patients. Depress Anxiety 29(7):646–651. doi:10.1002/da.21962

    CrossRef  PubMed  Google Scholar 

  • Wagner B, Schulz W, Knaevelsrud C (2012b) Efficacy of an Internet-based intervention for posttraumatic stress disorder in Iraq: a pilot study. Psychiatry Res 195(1–2):85–88. doi:10.1016/j.psychres.2011.07.026

    CrossRef  PubMed  Google Scholar 

  • Wampold BE, Imel ZE, Laska KM, Benish S, Miller SD, Flückiger C, Del Re AC, Baardseth TP, Budge S (2010) Determining what works in the treatment of PTSD. Clin Psychol Rev 30(8):923–933. doi:10.1016/j.cpr.2010.06.005

    CrossRef  PubMed  Google Scholar 

  • Wang Z, Wang J, Maercker A (2013) Chinese My Trauma Recovery, a Web-based intervention for traumatized persons in two parallel samples: randomized controlled trial. J Med Internet Res 15(9):e213. doi:10.2196/jmir.2690

    CrossRef  PubMed  PubMed Central  Google Scholar 

  • Ware J, Kosinski M, Keller SD (1996) A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care 34(3):220–233

    CrossRef  PubMed  Google Scholar 

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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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Authors and Affiliations

  1. Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands

    Jeroen Ruwaard

  2. Department of Clinical Psychology, Universiteit van Amsterdam, Amsterdam, The Netherlands

    Alfred Lange

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  1. Jeroen Ruwaard
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Correspondence to Jeroen Ruwaard .

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Editors and Affiliations

  1. Department of Clinical Neuroscience Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden

    Nils Lindefors

  2. Department of Behavioural Sciences, Linköping University, Linköping, Sweden

    Gerhard Andersson

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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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