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Home-Based Clinical Video-Teleconferencing Technology for PTSD: A Patient Centered Model

Home-Based Clinical Video-Teleconferencing Technology for PTSD: A Patient Centered Model Leslie Morland, PsyD, Steven Thorpe, PhD., Ron Acierno, PhD. What is Clinical VideoTeleconferencing?. Why Use CVT?. VHA CVT Services FY 2003-2011. What Do We Know? Evidence Base for CVT.

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Home-Based Clinical Video-Teleconferencing Technology for PTSD: A Patient Centered Model

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  1. Home-Based Clinical Video-Teleconferencing Technology for PTSD: A Patient Centered Model Leslie Morland, PsyD, Steven Thorpe, PhD., Ron Acierno, PhD.

  2. What is Clinical VideoTeleconferencing?

  3. Why Use CVT?

  4. VHA CVT Services FY 2003-2011

  5. What Do We Know? Evidence Base for CVT

  6. Non-inferiority Trials Underway • Group Cognitive Processing Therapy (CPT) with male PTSD combat veterans • Individual Cognitive Processing Therapy (CPT) with female PTSD combat veterans • Individual Prolonged Exposure with male PTSD combat veterans

  7. PrimaryResearch Goal • Evaluate the efficacy of using Video Teleconferencing (VTC) modality as compared to the traditional face-to-face in-person (NP) modality for providing an evidence-based cognitive-behavioral group anger management intervention to veterans with PTSD. • Hypotheses: EBP over CVT modality will be as effective as in-person service delivery for providing CPT, PE, AMT... • 1: Clinical outcomes • 2: Process outcome • 3: Cost Outcomes

  8. Clinical Implications: • Data supports that using a video teleconferencing modality for providing an evidence-based anger group therapy treatment is as good as providing this treatment in a traditional face-to-face modality. Clinical efficacy for this modality was established. • Preliminary data support feasibility and effectiveness of using video teleconferencing for a CPT group intervention and PE and CPT individual intervention to treat PTSD directly. • Veterans reported an acceptance and willingness to use these services in the future & reported satisfaction & comfort this modality.

  9. Limitations of Traditional Model • Long Term Sustainment • Hi degree of Coordination • Personnel Cost • Facility Resources • Patient Burden • Staff Burden

  10. Home-based CVT • Provide Care in the home through MOVI or Jabber technology • Less need for coordination, space, travel reimbursements • Pilots under way through Portland and Charleston have demonstrated feasibility

  11. Home Based CVT • Providers reach remote Veterans via secure and encrypted software with two-way facing cameras • Providers from multiple disciplines can access their VA network and patients • Less need for coordination, • space, travel reimbursements

  12. PCL Scores across Time (N=33)

  13. PCL Scores across Time (N=33)

  14. Recently or Pending Funding • Comparison of Prolonged Exposure for PTSD in OIF-OEF Veterans Delivered In-Office vs. Home-Based Telemedicine vs. Home-Based In Person ModalitiesPIs: Thorp and Morland; Funding Approved FY12 (FY12-FY16) • Home-Based Cognitive-Behavioral Conjoint Therapy for PTSD via Video teleconference” In response to NIMH RFA titled Harnessing Advanced Health Technologies to Drive Mental Health Improvement“ PI: Morland

  15. Future Research Directions • Continue to evaluate when, how, & with whom technologies can be used to impact care with difficult to reach military populations. • Examine integration of different technology platforms to overcome barriers across the access to continuum of care.

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