Internet-delivered trauma-focused CBT study shows promising results



Traumatic experiences such as a mugging or car accident can lead to nightmares, flashbacks, and other mental reactions, and accessible therapy is needed to prevent problems from worsening.

Researchers at the Karolinska Institutet have now completed what may be the largest trauma-focused CBT assessment to date (iCBT-T) delivered over the internet for people who have recently experienced trauma. The study, published in Psychological Medication, shows promising results.

Trauma such as traffic accidents, assault or sexual abuse impact the victim’s mental health, causing symptoms such as flashbacks, mood swings, insomnia, hypervigilance and social isolation. According to international population data, the average risk of suffering a trauma is 70%.

The vast majority of people feel better mentally within about three months of the triggering event, but in 5 or 6 percent of cases the problems worsen into post-traumatic stress disorder (PTSD). It is a debilitating mental disorder that increases the risk of, among other things, suicide, drug and alcohol dependence, and general inability to work.

Accessible treatment needed

Intervention in the form of trauma-focused cognitive behavioral therapy (CBT-T) of limited duration is known to aid recovery after a traumatic event and thus reduce the risk of PTSD and other disorders. To make treatment more accessible to more people, for example when an entire community suffers a natural disaster or violence, a digital option is needed.

Researchers at the Karolinska Institutet have now evaluated the ability of iCBT-T to reduce symptoms of trauma at an early stage. The study involved 102 patients, half of whom had seen a doctor after exposure to trauma and about a third were on sick leave. More than two-thirds of the group met the criteria for a psychiatric diagnosis.

Assaults, deaths, rapes and traffic accidents were the most common causes of trauma for participants, with the event occurring on average one month before. Participants in the control group were on a waiting list for iCBT-T.

Natural recovery for the most part

The study was conducted between October 2019 and June 2020. For three weeks, 51 participants received CBT-T via the internet, with the control group of 51 participants receiving iCBT-T after seven weeks. Participants were randomly assigned to one or the other of the groups, both of which were followed up after six months.

We used a waiting list to monitor natural recovery from post-traumatic mental distress. The natural recovery process, which is seen in the majority of affected people, normally occurs within the first three months of exposure to a traumatic event. “

Erik Andersson, final study author, professor of clinical psychology, Department of Clinical Neurosciences, Karolinska Institutet

Their results show that a time-limited intervention offered by the Internet for people who have recently experienced a trauma such as rape, assault or traffic accident, is effective in reducing symptoms of PTSD both short and long. long term.

“There has been no evidence-based intervention to help people who have recently suffered trauma, so our findings may be of great importance to our area of ​​research,” says the study’s first author, Maria Bragesjö, psychologist and researcher at the Department of Clinical Neurosciences, Karolinska Institute. “There are also many misconceptions that traumatized people, such as victims of sexual violence, are unable to respond to therapy provided through the Internet. Our findings may lead more people to seek help for recover and restore their quality of life distressing events. “

One of the weaknesses of the study is that participants were selected using a self-report form rather than a diagnostic interview for PTSD.


Journal reference:

Bragesjö, M., et al. (2021) Internet-provided condensed prolonged exposure provided shortly after trauma: a randomized trial. Psychological medicine.



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