Online PTSD Treatment for Young People and Carers - Case Series

NCT ID: NCT03935035

Last Updated: 2019-08-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

6 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-04-01

Study Completion Date

2019-12-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Post Traumatic Stress Disorder (PTSD) is prevalent and impairing in children and young people. Effective face to face treatments exist, including Cognitive Therapy for PTSD (CT-PTSD), developed by the researchers' group. However, few young people access effective treatments.

The researchers are therefore developing a website and smart-phone App that will improve accessibility of this treatment by allowing trained therapists to deliver CT-PTSD over the internet (iCT) to young people (12-17 years old) with PTSD. This study aims to provide an initial evaluation of iCT. This will be done by running an uncontrolled case series with 6 young people.

The objectives of the case series are to: to gauge acceptability of the programme to young people, carers, and therapists; to measure adherence to the programme; to test the battery of measures for acceptability; and to obtain estimates of clinical change.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

PTSD is prevalent among young people, and is distressing and impairing. Face-to-face trauma-focussed CBT (TFCBT) is an effective short-term therapy for PTSD in young people. The researchers previously developed Cognitive Therapy for PTSD (CT-PTSD) in children and young people, and have shown in 2 published RCTs that it is efficacious when delivered face-to-face. However, most young people with PTSD do not receive effective, evidence-based treatments. This is in part due to under-capacity in NHS CAMHS, and in part due to the burden and inconvenience to young people in attending face-to-face appointments in a clinic. In this project the researchers propose to make CT for PTSD widely available to young people by delivering the therapy via the internet, with therapist support. The rationale for this approach is that (1) young people will engage with internet-delivered therapy, and online therapies for other disorders such as depression have demonstrated efficacy in clinical trials; (2) effective online therapies for adults with PTSD have been developed and evaluated; (3) no online treatments for young people with PTSD have yet been developed.

An uncontrolled case series will be run with N=6 young patients. Young people who are referred to the South London and Maudsley NHS Foundation Trust CAMHS service, and who meet the eligibility criteria, will be invited to take part in the case series. After both the young person and their carer or parent have provided informed consent (or assent), they will complete several baseline assessment measures. These measures will be completed at a face-to-face meeting in the Tier 4 National and Specialist Trauma, Anxiety and Depression (TAD) NHS clinic, and online. The young person and family will meet the young person's therapist face-to-face at this initial assessment meeting. After assessment, the young person that will be treated remotely using iCT for up to 12 weeks.

This treatment will include regular (at least weekly) telephone contact with the therapist, and other contact with the therapist during the week using a messaging function within the iCT App. The young person will be asked to complete a mood rating and a brief 8-item questionnaire about PTSD symptoms once a week during treatment: this mirrors what happens during standard face-to-face care in the TAD NHS clinic. At mid treatment, the young person will be asked to complete one additional 25-item questionnaire about thoughts related to trauma. Risk monitoring including monitoring of adverse events will be carried out during weekly phone calls.

Post treatment, the young person will attend the TAD NHS clinic for a face-to-face clinical interview and will complete a questionnaire pack online. At this meeting, the young person will complete feedback ratings on the acceptability of the design of online treatment modules using 4 simple 0-10 scales (about the overall design appeal, ease-of-use, comprehension, and likelihood of recommending the program to a friend with similar problems). The young person will be interviewed about their experience of using the iCT program (an "exit interview"). Acceptability of the questionnaire battery will be assessed by asking young people to complete an end-of-treatment rating using a 0-100 scale. The young people's parents or carers will also take part in a clinical interview about the young person, will complete a questionnaire pack online, and will be invited to take part in an interview about their experience as a parent or carer of using the iCT program.

N=6 young people will be treated as part of this case series. Young people's and their parents' qualitative feedback on the acceptability of the iCT programme will be reported using data from the exit interviews and from the acceptability rating scales. Averse events during therapy will also be reported. Reliable Clinical Change on a standardised questionnaire of PTSD symptoms (the CPSS-5) will be reported as a preliminary signal of clinical effect. Reliable Clinical Improvement is shown by a reduction of 8 points on the CPSS-5. Acceptability of the outcome measures will be gauged by scrutinising completion rates.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Post Traumatic Stress Disorder

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

NA

Intervention Model

SINGLE_GROUP

Uncontrolled case series
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

internet-Cognitive Therapy for PTSD

This is a single-arm study. All participants will receive the same therapist supported, internet-delivered intervention.

Group Type EXPERIMENTAL

internet-delivered Cognitive Therapy for PTSD (iCT)

Intervention Type BEHAVIORAL

Participants will receive 10 hours of Cognitive Therapy for PTSD over 12 weeks, with a baseline assessment at the beginning and follow up interview at the end of treatment. The treatment consists of online modules (9 core modules, 11 optional modules and parent/carer modules) and a weekly phone call with a qualified and trained therapist.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

internet-delivered Cognitive Therapy for PTSD (iCT)

Participants will receive 10 hours of Cognitive Therapy for PTSD over 12 weeks, with a baseline assessment at the beginning and follow up interview at the end of treatment. The treatment consists of online modules (9 core modules, 11 optional modules and parent/carer modules) and a weekly phone call with a qualified and trained therapist.

Intervention Type BEHAVIORAL

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Participant is aged 12-17 years old
* Main presenting problem is PTSD and there is a not a co-morbid problem that would preclude treatment of PTSD.
* PTSD symptoms related to a single trauma
* Participant has access to compatible smartphone and larger computing device (e.g. laptop, desktop computer, iPad) with internet access.
* Participant is proficient in speaking and writing in the English language, sufficient to participate in treatment without an interpreter.

Exclusion Criteria

* Brain damage assessed by clinical interview with parents / carers
* Intellectual disability assessed by clinical interview with parents / carers
* Pervasive developmental disorder or neurodevelopmental disorder assessed by clinical interview with parents / carers
* Other psychiatric diagnosis that requires treatment before PTSD, determined by clinical interview and questionnaires
* Moderate to high risk to self assessed in clinical interview
* Ongoing trauma-related threat assessed in clinical interview
* Started treatment with psychotropic medication, or changed medication, within the last 2 months, assessed in clinical interview
* Currently receiving another psychological treatment, assessed in interview
* Have already received Trauma Focused CBT in relation to the same traumatic event that the young person is currently seeking treatment for.
Minimum Eligible Age

12 Years

Maximum Eligible Age

17 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Medical Research Council

OTHER_GOV

Sponsor Role collaborator

South London and Maudsley NHS Foundation Trust

OTHER

Sponsor Role collaborator

King's College London

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Patrick Smith, PhD

Role: PRINCIPAL_INVESTIGATOR

King's College London

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

King's College London/ South London and Maudsley NHS Foundation Trust

London, , United Kingdom

Site Status RECRUITING

University of East Anglia/ Norfolk and Suffolk NHS Foundation Trust

Norwich, , United Kingdom

Site Status NOT_YET_RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

United Kingdom

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Patrick A Smith, PhD

Role: CONTACT

02078480506 ext. 0506

Monica Gupta, MSc

Role: CONTACT

02078480580 ext. 0580

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Patrick Smith

Role: primary

02078480506

Richard Meiser-Stedman

Role: primary

01603 593601

References

Explore related publications, articles, or registry entries linked to this study.

Foa EB, Johnson KM, Feeny NC, Treadwell KR. The child PTSD Symptom Scale: a preliminary examination of its psychometric properties. J Clin Child Psychol. 2001 Sep;30(3):376-84. doi: 10.1207/S15374424JCCP3003_9.

Reference Type BACKGROUND
PMID: 11501254 (View on PubMed)

Goodman R. Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry. 2001 Nov;40(11):1337-45. doi: 10.1097/00004583-200111000-00015.

Reference Type BACKGROUND
PMID: 11699809 (View on PubMed)

McKinnon A, Smith P, Bryant R, Salmon K, Yule W, Dalgleish T, Dixon C, Nixon RD, Meiser-Stedman R. An Update on the Clinical Utility of the Children's Post-Traumatic Cognitions Inventory. J Trauma Stress. 2016 Jun;29(3):253-8. doi: 10.1002/jts.22096. Epub 2016 May 18.

Reference Type BACKGROUND
PMID: 27191657 (View on PubMed)

Perrin, S., Meiser-Stedman, R., & Smith, P. (2005). The Children's Revised Impact of Event Scale (CRIES): validity as a screening instrument for PTSD. Behavioural and Cognitive Psychotherapy, 33(4), 487-498.

Reference Type BACKGROUND

Pynoos, R. S., Weathers, F. W., Steinberg, A. M., Marx, B. P., Layne, C. M., Kaloupek, D. G., Schnurr, P. P., Keane, T. M., Blake, D. D., Newman, E., Nader, K. O., & Kriegler, J. A. (2015). Clinician-Administered PTSD Scale for DSM-5 - Child/Adolescent Version.

Reference Type BACKGROUND

Provided Documents

Download supplemental materials such as informed consent forms, study protocols, or participant manuals.

Document Type: Study Protocol and Statistical Analysis Plan

View Document

Document Type: Informed Consent Form: Assent Form for participants aged 12-15

View Document

Document Type: Informed Consent Form: Consent Form for participants aged 16-17

View Document

Document Type: Informed Consent Form: Parental consent form for parental participation

View Document

Document Type: Informed Consent Form: Parental consent form for participants aged 12-15

View Document

Related Links

Access external resources that provide additional context or updates about the study.

https://ueaeprints.uea.ac.uk/50579/1/Perrin_et_al_2005_BCP_postprint.pdf

Link to Perrin, Meiser-Stedman, \& Smith, (2005). The Children's Revised Impact of Event Scale (CRIES): validity as a screening instrument for PTSD

https://www.ptsd.va.gov/professional/assessment/documents/CAPS-CA-5.pdf

Link to Pynoos et al., (2015). Clinician-Administered PTSD Scale for DSM-5 - Child/Adolescent Version

https://scholar.google.co.uk/scholar?hl=en&as_sdt=0%2C5&q=Chorpita%2C+B.+F.%2C+Ebesutani%2C+C.%2C+%26+Spence%2C+S.+H.+%282014%29.+Revised+children%E2%80%99s+anxiety+and+depression+scale+user%E2%80%99s+guide.+Unpublished+Users+Guide%2C+University+of+California%2C+Los+Angeles.+&btnG=

Chorpita, B. F., Ebesutani, C., \& Spence, S. H. (2014). Revised children's anxiety and depression scale user's guide. Unpublished Users Guide, University of California, Los Angeles. http://www. childfirst. ucla. edu/RCADSUsersGuide20140711.pdf.

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

MR/P017355/1

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.