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Early‐stage randomised controlled trial of therapist‐supported online cognitive therapy for post‐traumatic stress disorder in young people.

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Title: Early‐stage randomised controlled trial of therapist‐supported online cognitive therapy for post‐traumatic stress disorder in young people.
Authors: Smith, Patrick, Ehlers, Anke, Carr, Ewan, Clark, David M., Dalgleish, Tim, Forbes, Gordon, Goldsmith, Kimberley, Griffiths, Helena, Gupta, Monica, King, Dorothy, Miles, Sarah, Plant, Dominic T., Smith, Anne, Steward, Jess, Yule, William, Meiser‐Stedman, Richard
Source: Journal of Child Psychology & Psychiatry. Aug2025, Vol. 66 Issue 8, p1117-1128. 12p.
Subjects: Treatment of post-traumatic stress disorder, Anxiety treatment, Patient compliance, Poisson distribution, Research funding, Medical care, Evaluation of human services programs, Blind experiment, Pilot projects, Statistical sampling, Questionnaires, Logistic regression analysis, Internet, Descriptive statistics, Psychoeducation, Randomized controlled trials, Odds ratio, Statistics, Intraclass correlation, Cognitive therapy, Comparative studies, Confidence intervals, Psychological tests, Data analysis software, Mental depression, Regression analysis, Adolescence
Geographic Terms: United Kingdom
Abstract: Background: Effective face‐to‐face treatments for Post‐Traumatic Stress Disorder (PTSD) are available, but most young people with PTSD do not receive effective treatment. Therapist‐supported online Cognitive Therapy has the potential to improve accessibility of effective treatment. This early‐stage trial gathered data on the feasibility, acceptability, and initial signal of clinical efficacy of a novel online Cognitive Therapy program for young people with PTSD. Methods: A two‐arm, parallel‐groups, single‐blind, early‐stage feasibility RCT compared online Cognitive Therapy to a waitlList condition. Participants were N = 31 adolescents (12–17 years‐old) with a diagnosis of PTSD, randomised in a 1:1 ratio using minimisation. Thresholds for progression to a larger trial were set a priori for recruitment rate, data completeness, and the initial signal of clinical efficacy. The primary clinical outcome was PTSD diagnosis at 16 weeks post‐randomisation. Secondary clinical outcomes were continuous measures of PTSD, depression, and anxiety at 16 weeks; and at 38 weeks in the online Cognitive Therapy arm. Results: All pre‐determined feasibility thresholds for progression to a larger trial were met. We recruited to target at a rate of 1–2 participants/month. No patient dropped out of therapy; 94% of all participants were retained at 16 weeks. At 16‐weeks, the intention‐to‐treat (ITT) effect adjusted odds ratio was 0.20 (95% CI, 0.02, 1.42), indicating that the odds of meeting PTSD caseness after online therapy were 80% lower than after the waitlist (10/16 participants met PTSD caseness after therapy compared to 11/13 after WL). Effect‐size estimates for all secondary clinical outcomes were large‐moderate; improvements were sustained 38 weeks after online Cognitive Therapy. Conclusions: Therapist‐supported online Cognitive Therapy for PTSD is acceptable to young people and has potential for meaningful and sustained clinical effects. A larger trial appears feasible to deliver. Further work is needed to refine the intervention and its delivery and to evaluate it in a larger confirmatory trial. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Child Psychology & Psychiatry is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Early‐stage randomised controlled trial of therapist‐supported online cognitive therapy for post‐traumatic stress disorder in young people.
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  Data: <searchLink fieldCode="JN" term="%22Journal+of+Child+Psychology+%26+Psychiatry%22">Journal of Child Psychology & Psychiatry</searchLink>. Aug2025, Vol. 66 Issue 8, p1117-1128. 12p.
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  Data: Background: Effective face‐to‐face treatments for Post‐Traumatic Stress Disorder (PTSD) are available, but most young people with PTSD do not receive effective treatment. Therapist‐supported online Cognitive Therapy has the potential to improve accessibility of effective treatment. This early‐stage trial gathered data on the feasibility, acceptability, and initial signal of clinical efficacy of a novel online Cognitive Therapy program for young people with PTSD. Methods: A two‐arm, parallel‐groups, single‐blind, early‐stage feasibility RCT compared online Cognitive Therapy to a waitlList condition. Participants were N = 31 adolescents (12–17 years‐old) with a diagnosis of PTSD, randomised in a 1:1 ratio using minimisation. Thresholds for progression to a larger trial were set a priori for recruitment rate, data completeness, and the initial signal of clinical efficacy. The primary clinical outcome was PTSD diagnosis at 16 weeks post‐randomisation. Secondary clinical outcomes were continuous measures of PTSD, depression, and anxiety at 16 weeks; and at 38 weeks in the online Cognitive Therapy arm. Results: All pre‐determined feasibility thresholds for progression to a larger trial were met. We recruited to target at a rate of 1–2 participants/month. No patient dropped out of therapy; 94% of all participants were retained at 16 weeks. At 16‐weeks, the intention‐to‐treat (ITT) effect adjusted odds ratio was 0.20 (95% CI, 0.02, 1.42), indicating that the odds of meeting PTSD caseness after online therapy were 80% lower than after the waitlist (10/16 participants met PTSD caseness after therapy compared to 11/13 after WL). Effect‐size estimates for all secondary clinical outcomes were large‐moderate; improvements were sustained 38 weeks after online Cognitive Therapy. Conclusions: Therapist‐supported online Cognitive Therapy for PTSD is acceptable to young people and has potential for meaningful and sustained clinical effects. A larger trial appears feasible to deliver. Further work is needed to refine the intervention and its delivery and to evaluate it in a larger confirmatory trial. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Journal of Child Psychology & Psychiatry is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/jcpp.14124
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        Text: English
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      – SubjectFull: Treatment of post-traumatic stress disorder
        Type: general
      – SubjectFull: Anxiety treatment
        Type: general
      – SubjectFull: Patient compliance
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      – SubjectFull: Poisson distribution
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      – SubjectFull: United Kingdom
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      – TitleFull: Early‐stage randomised controlled trial of therapist‐supported online cognitive therapy for post‐traumatic stress disorder in young people.
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