Table 20, Characteristics of Included Studies - Internet-Delivered Cognitive Behavioural Therapy for Post-Traumatic Stress Disorder: A Health Technology Assessment

First Author (Publication Year), Country	Study Design (Data Analysis)	Study Objectives	Participant Characteristics, Sample Size (n)	Inclusion Criteria	Intervention Type	Data Collection
Hundt (2018), US⁹⁹	NS (grounded theory)	To understand the attitudes, experiences, and barriers and facilitators to treatment for veterans who enrolled in a VA PTSD specialty clinic and were offered either PE or CPT	24 veterans	Veterans with a primary psychiatric diagnosis of PTSD who were admitted to the PTSD clinic and judged to be appropriate to for PE or CPT, offered PE or CPT, but not starting PE or CPT within 12 months	PE and CPT	Interviews
Cook (2017), US100	NS (grounded theory)	To assess how residential treatment providers within the VA conceptualize and address patient readiness for trauma-focused EBTs for PTSD	99 psychologists, 62 social workers, 4 psychiatrists, 3 nurses, 4 “other”	NS	PE and CPT	Semi-structured telephone interview
Hundt (2017), US101	NS (grounded theory)	To explore how veterans living with PTSD experience the use of EBT in their treatment	23 veterans	Veterans who had completed at least 8 sessions of PE or CPT in a VA PTSD clinic	PE and CPT	Interviews
Stige (2017), Norway¹⁰²	NS (hermeneutic phenomenological approach)	To explore how former trauma clients experienced the inclusion of skill training in their treatment, their ways of relating to and using these skills, and how this changed over time	13 patients	NS	Skills training components of a trauma specific stabilization group	Semi-structured interviews conducted over two time points
Tong (2017), Australia¹⁰³	NS (interpretive phenomenological approach)	To explore young people’s reactions to a trauma-focused treatment for PTSD in FEP	8 participants	Individuals aged 15 to 25 years with a DSM-IV psychotic disorder or mood disorder with psychotic features and having current trauma symptoms that meet the full criteria for PTSD using CAPS	Intervention drawing on principles of CBT	Semi-structured interviews
Whealin (2016), US111	Mixed-methods (content analysis)	To identify the types of eHealth tools that veterans with PTSD and comorbid CMCs use, understand how they currently use eHealth technology to self-manage their unique health care needs, and identify new e-health resources that veterans feel would empower them to better manage their health	10 veterans	Veterans with three or more chronic conditions and experience using technology to help them care for their health or manage their health care, and having received care at the VA facility	NS	Focus groups
Hamblen (2015), US104	NS (NS)	To examine VA PTSD clinic director perspectives on the implementation of PE and CPT in PTSD outpatient programs to better understand the local challenges be faced	31 psychologists, 5 social workers, 2 psychiatrists	NS	PE and CPT	Semi-structured interviews
Hundt (2015), US105	NS (grounded theory)	To enhance knowledge of facilitators to EBP initiation by examining veterans’ real-world experiences initiating EBP for PTSD and how they overcame barriers to EBP in their own lives	23 veterans	Veterans who had completed at least 8 sessions of EBP in a VA PTSD clinic	PE and CPT	Interviews
McCormack (2015), Australia¹⁰⁶	NS (interpretive phenomenological analysis)	To explore the “lived” experience of trauma-focused therapists working with mental health in-patients with complex trauma histories	2 psychiatric consultants, 1 clinical psychologist, 1 psychologist/clinical manager	NS	NS	Interviews
Cook (2014), US107	NS (NS)	To present VA residential PTSD treatment provider perceptions of dissuading factors to the use of PE and CPT	110 psychologist, 66 social workers, 11 nurses, 5 psychiatrists, 6 “other”	NS	PE and CPT	Semi-structured telephone interviews
Lawrence (2014), UK108	NS (interpretive phenomenological analysis)	To produce an in-depth understanding of the experience of completing a course of compassion-focused therapy for PTSD and the process of developing self-compassion	9 patients	People who had completed two CFT groups for PTSD	CFT	Interviews
Lowe (2014), UK¹⁰⁹	Phenomenological and idiographic (interpretive phenomenological analysis)	To gain an understanding of the aspects of trauma-focused CBT for PTSD that service users find important in contributing to their improvement	9 patients	NS	Trauma-focused CBT	Interviews
Reeves (2014), Canada¹¹⁰	Naturalistic paradigm informed by Indigenous inquiry(grounded theory)	Investigate the use of traditional Indigenous healing alongside Western mental health services to address issues related to recovery from sexual trauma at a culture-based multiservice health centre	3 traditional healers/medicine people, 5 traditional counsellors, 1 traditional counsellor/traditional teacher, 1 Elder	NS	NS	Two sets of interviews

First Author (Publication Year), Country

Study Design (Data Analysis)

Study Objectives

Participant Characteristics, Sample Size (n)

Inclusion Criteria

Intervention Type

Data Collection

Hundt (2018), US⁹⁹

NS (grounded theory)

To understand the attitudes, experiences, and barriers and facilitators to treatment for veterans who enrolled in a VA PTSD specialty clinic and were offered either PE or CPT

24 veterans

Veterans with a primary psychiatric diagnosis of PTSD who were admitted to the PTSD clinic and judged to be appropriate to for PE or CPT, offered PE or CPT, but not starting PE or CPT within 12 months

PE and CPT

Interviews

Cook (2017), US100

NS (grounded theory)

To assess how residential treatment providers within the VA conceptualize and address patient readiness for trauma-focused EBTs for PTSD

99 psychologists,

62 social workers,

4 psychiatrists,

3 nurses,

4 “other”

PE and CPT

Semi-structured telephone interview

Hundt (2017), US101

NS (grounded theory)

To explore how veterans living with PTSD experience the use of EBT in their treatment

23 veterans

Veterans who had completed at least 8 sessions of PE or CPT in a VA PTSD clinic

PE and CPT

Interviews

Stige (2017), Norway¹⁰²

NS (hermeneutic phenomenological approach)

To explore how former trauma clients experienced the inclusion of skill training in their treatment, their ways of relating to and using these skills, and how this changed over time

13 patients

Skills training components of a trauma specific stabilization group

Semi-structured interviews conducted over two time points

Tong (2017), Australia¹⁰³

NS (interpretive phenomenological approach)

To explore young people’s reactions to a trauma-focused treatment for PTSD in FEP

8 participants

Individuals aged 15 to 25 years with a DSM-IV psychotic disorder or mood disorder with psychotic features and having current trauma symptoms that meet the full criteria for PTSD using CAPS

Intervention drawing on principles of CBT

Semi-structured interviews

Whealin (2016), US111

Mixed-methods (content analysis)

To identify the types of eHealth tools that veterans with PTSD and comorbid CMCs use, understand how they currently use eHealth technology to self-manage their unique health care needs, and identify new e-health resources that veterans feel would empower them to better manage their health

10 veterans

Veterans with three or more chronic conditions and experience using technology to help them care for their health or manage their health care, and having received care at the VA facility

Focus groups

Hamblen (2015), US104

NS (NS)

To examine VA PTSD clinic director perspectives on the implementation of PE and CPT in PTSD outpatient programs to better understand the local challenges be faced

31 psychologists,

5 social workers,

2 psychiatrists

PE and CPT

Semi-structured interviews

Hundt (2015), US105

NS (grounded theory)

To enhance knowledge of facilitators to EBP initiation by examining veterans’ real-world experiences initiating EBP for PTSD and how they overcame barriers to EBP in their own lives

23 veterans

Veterans who had completed at least 8 sessions of EBP in a VA PTSD clinic

PE and CPT

Interviews

McCormack (2015), Australia¹⁰⁶

NS (interpretive phenomenological analysis)

To explore the “lived” experience of trauma-focused therapists working with mental health in-patients with complex trauma histories

2 psychiatric consultants,

1 clinical psychologist,

1 psychologist/clinical manager

Interviews

Cook (2014), US107

NS (NS)

To present VA residential PTSD treatment provider perceptions of dissuading factors to the use of PE and CPT

110 psychologist,

66 social workers,

11 nurses,

5 psychiatrists,

6 “other”

PE and CPT

Semi-structured telephone interviews

Lawrence (2014), UK108

NS (interpretive phenomenological analysis)

To produce an in-depth understanding of the experience of completing a course of compassion-focused therapy for PTSD and the process of developing self-compassion

9 patients

People who had completed two CFT groups for PTSD

CFT

Interviews

Lowe (2014), UK¹⁰⁹

Phenomenological and idiographic (interpretive phenomenological analysis)

To gain an understanding of the aspects of trauma-focused CBT for PTSD that service users find important in contributing to their improvement

9 patients

Trauma-focused CBT

Interviews

Reeves (2014), Canada¹¹⁰

Naturalistic paradigm informed by Indigenous inquiry(grounded theory)

Investigate the use of traditional Indigenous healing alongside Western mental health services to address issues related to recovery from sexual trauma at a culture-based multiservice health centre

3 traditional healers/medicine people,

5 traditional counsellors,

1 traditional counsellor/traditional teacher,

1 Elder

Two sets of interviews

From: Appendix 13, Characteristics of Included Primary Studies — Perspectives and Experiences

Cover of Internet-Delivered Cognitive Behavioural Therapy for Post-Traumatic Stress Disorder: A Health Technology Assessment

Internet-Delivered Cognitive Behavioural Therapy for Post-Traumatic Stress Disorder: A Health Technology Assessment [Internet].

CADTH Optimal Use Report, No. 9.3b.

Young C, Sinclair A, Black C, et al.

Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2019 Dec.

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Table 20Characteristics of Included Studies