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

Andy P. Siddaway (Lead Author), Richard Meiser-Stedman, Verity Chester, Jack Finn, Cliodhna O Leary, David Peck, Camilla Loveridge

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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.
Original languageEnglish
Pages (from-to)675-685
Number of pages11
JournalDepression and Anxiety
Volume39
Issue number10-11
Early online date27 May 2022
DOIs
Publication statusPublished - Oct 2022

Keywords

  • cognitive-behavioral
  • effectiveness
  • efficacy
  • posttraumatic stress disorder
  • review
  • self-help
  • therapy

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