Many South Africans who are exposed to trauma and suffer from posttraumatic stress order (PTSD) do not always receive the treatment they need to deal with crippling and disabling flashbacks, nightmares, stress, and anxiety.
They don't receive the much-needed treatment because of overburdened public healthcare services and difficulty accessing these services when available.
Amid these circumstances, a counsellor-supported PTSD Coach-mobile app (PTSD Coach-CS) offers hope to PTSD sufferers. The freely available app could help broaden access to psychiatric care and remove some barriers to treatment.
Researchers from Stellenbosch University (SU) and the University of Amsterdam (UvA) evaluated the feasibility and effectiveness of a four-session PTSD Coach-CS intervention in reducing PTSD, depression, anxiety, and stress symptoms in a group of adults with PTSD who live in an area with limited healthcare resources.
The team consisted of the lead researcher Dr Erine Bröcker, and Dr Sharain Suliman, Prof Martin Kidd, Lyrése Greyvenstein, and Prof Soraya Seedat from the Department of Psychiatry at SU, as well as Prof Miranda Olff from the Department of Psychiatry at the UvA.
Their findings were recently published in Cambridge Prisms: Global Mental Health.
The researchers say that to their knowledge, this was the first time the app, which was released in the United States in 2011, was evaluated in South Africa and was also novel in supplementing delivery with less specialised mental health services (registered counsellors opposed to psychiatrists or psychologists).
The PTSD Coach app was downloaded onto participants' smartphones, and they were provided with mobile data. They attended four weekly counsellor-supported sessions of 30-40 minutes each during which the focus was on (i) setting an agenda for the session; (ii) gathering feedback on the last session; (iii) reviewing the week (i.e., enquiring about the frequency of app use during the week) and homework (i.e., using app tools); (iv) accessing and using selected symptoms and tools, with the counsellor available to assist with language and technical difficulties; and (v) agreeing on homework for the following week (i.e., identifying tools to explore more).
Participants were encouraged to use the app outside of the sessions and to review the material covered in each session. A qualified clinical psychologist monitored all participants' response to treatment for PTSD, depression, anxiety and stress symptom changes at various stages before and after the treatment.
According to the researchers, the results of their study show that PTSD and stress symptoms improved over time in the PTSD Coach-CS group.
“The participants were positive about the counsellor-supported intervention sessions and used the app daily to five times per week outside the sessions. They perceived the app as moderately to very helpful and were overall very satisfied with it. They also felt moderately to highly certain about their abilities to manage PTSD symptoms."
“Using the app provided a way for them to talk about what they have been experiencing and to learn about treatments for PTSD."
“Our findings suggest that a freely available mental health-focused mobile-based intervention is a feasible, suitable and potentially effective treatment alternative for adults with PTSD in areas with limited resources," add the researchers.
According to them, mental health-focused mobile-based interventions, such as the PTSD Coach app, hold promise as they provide greater capacity for support, are available at hand and immediately, can be anonymous and private, and appear cost-effective.
The researchers say the results support the usefulness of the app in a community with limited healthcare resources, emphasising that it is not intended to replace professional mental health care.
They emphasise the need for more studies in larger samples to fully establish the effectiveness of the PTSD Coach-CS intervention in reducing the severity of PTSD and comorbid symptoms.
The researchers add that it would also be important to consider methods that can further bridge treatment barriers in South Africa such as evaluating the intervention at primary health care clinics in the community to limit transport difficulties.
“Incorporating the PTSD Coach app into usual care could also be explored to offer support whilst patients are on waiting lists, or between sessions and after they have received care."
- Source: Bröcker E, Olff M, Suliman S, Kidd M, Greyvenstein L and Seedat S (2024). A counsellor-supported 'PTSD Coach' intervention versus enhanced Treatment-as-Usual in a resource-constrained setting: A randomised controlled trial. Cambridge Prisms: Global Mental Health, 11, e7, 1–15. doi: org/10.1017/gmh.2023.92
MORE ABOUT PTSD COACH-CS
- Released by the United States' Department of Defence and Veteran Affairs in 2011; updated in 2018.
- Self-managed app for trauma-exposed adults.
- Freely available with no cost after download.
- Does not require an internet connection after download.
- Utilises limited phone memory (130 megabytes).
- Suitable for the visually and hearing impaired.
- App features divided into four core functions: Learn (psychoeducation about PTSD symptoms); Track progress (methods for individual symptom tracking and feedback on progress made); Manage symptoms (tools to manage PTSD symptoms) and Get support (learning about and identifying professional treatment services).
- Can be downloaded from iStore: https://bit.ly/3SVyLXT or Google Play Store: https://bit.ly/3wAvrtW
Photo courtesy of Pickpik.
