Walsh, Tara; (2024) “Shame is at the root of everything, it's been a part of me since I can remember". Online therapy and disclosures of shame: An exploration into the experiences of clients presenting with PTSD. Doctoral thesis (D.Clin.Psy), UCL (University College London).

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Abstract

Aims: Digital therapy interventions for trauma have long been evidenced as an efficacious method of trauma treatment. However, there is no review of the literature exploring the use of digital technology in engagement with remote therapist-facilitated interventions. This narrative synthesis aimed to explore this by examining treatment efficacy and engagement with treatment.// Method: Studies were identified through a systematic literature search of PsychINFO, Medline, and Embase from inception to 25th October 2023. The search identified 842 studies which were reviewed by two independent raters against a prespecified eligibility criteria including research design, intervention characteristics, population characteristics, and the type of outcome measures. This process yielded 13 eligible studies that are included in this review.// Results: A narrative synthesis demonstrated that internet-delivered trauma interventions vary considerably in treatment approach, symptom reduction, attrition rates, and therapist contact. Results were impacted by study design, sample size, and consistency of therapeutic approach.// Conclusions: In conclusion, although digital therapies for PTSD have been found to be effective, continuous research is crucial to refine methodologies, improve clinical application, and gain a deeper understanding of the factors affecting treatment effectiveness and patient engagement.

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