Peer-reviewed article
Feasibility and acceptability of therapist-guided, asynchronous, internet-delivered trauma-focused CBT for adolescents with PTSD: a single-group feasibility trial in Sweden.
Mattelin E, Weyler H, Andersson R, Paulsen J, Tielman S et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study tested an online therapy programme delivered by therapists for teenagers aged 13-17 with post-traumatic stress disorder (PTSD) in Sweden. The 12-week programme combined trauma-focused cognitive behavioural therapy with modules for parents. The programme was well-received, had high completion rates, and teenagers showed significant improvements in PTSD symptoms, with nearly half no longer meeting PTSD criteria after treatment.
Key points
- 22 adolescents (82% female) with primary PTSD completed the 12-week therapist-guided internet-delivered TF-CBT programme
- High retention and adherence, with favourable satisfaction and credibility ratings
- Large reductions in PTSD symptoms: Cohen's d=1.27 on clinician-rated scale and d=1.51 on self-report scale at 1-month follow-up
- 47.6% of participants no longer met diagnostic criteria for PTSD at follow-up
- No intervention-related serious adverse events reported
Limitations
This was a single-group feasibility study with a small sample size (n=22) and no comparison group, so we cannot determine whether observed improvements would have occurred without the intervention or how this approach compares to face-to-face therapy. The study was conducted in one high-income country and findings may not generalise to other settings or populations.
Abstract
Objectives Trauma-focused cognitive behavioural therapy (TF-CBT) is the established first-line treatment for paediatric post-traumatic stress disorder (PTSD), but access to evidence-based care remains limited. This study aimed to evaluate the feasibility and acceptability of a therapist-guided, 12 week, internet-delivered TF-CBT (iTF-CBT) programme for adolescents with PTSD and to explore preliminary changes in PTSD symptoms. Design Single-group feasibility trial. Setting Save the Children, Sweden. Participants Twenty-two adolescents (13-17 years, 82% female) with primary PTSD. Interventions A 12 week, therapist-guided, asynchronous, internet-delivered TF-CBT comprising eight modules and parallel caregiver modules with joint adolescent-caregiver activities. Outcomes Feasibility measures included recruitment pace, participant retention, treatment adherence (module completion) and therapist time. Acceptability was evaluated through satisfaction, credibility, negative effects and reported adverse events. Within-group changes in PTSD severity using independent evaluator-rated Clinician-Administered PTSD Scale (CAPS-CA-5) and the self-reported Child and Adolescent Trauma Screen 2 (CATS-2) were used as indicators of potential clinical change. Assessments occurred at baseline, during treatment, post-treatment and at 1 month follow-up (primary endpoint). Results Recruitment was completed after 7 months of active enrolment. Retention and adherence were high, satisfaction and credibility ratings were favourable, and no intervention-related serious adverse events occurred. Within-group improvements were observed at the primary endpoint, with large reductions on CAPS-CA-5 (Cohen's d=1.27) and CATS-2 (Cohen's d=1.51). At follow-up, 47.6% of participants no longer met criteria for PTSD. Conclusions Therapist-guided iTF-CBT for adolescents with PTSD was safe, feasible, acceptable and associated with potentially meaningful symptom improvements. These findings support further evaluation in larger, controlled trials to determine efficacy, cost-effectiveness and long-term outcomes. Trial registration number NCT06185244.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- 12-week therapist-guided, asynchronous, internet-delivered trauma-focused CBT (iTF-CBT) comprising eight modules with parallel caregiver modules and joint activities
- Population
- 22 adolescents aged 13-17 years (82% female) with primary PTSD in Sweden
Key finding
Large reductions in PTSD severity at primary endpoint: Cohen's d=1.27 on clinician-rated CAPS-CA-5 and d=1.51 on self-reported CATS-2