Feasibility and acceptability of remote technologies for the treatment of trauma- and stressor-related disorders in adults: mixed-methods systematic review.

Abstract

Background: Trauma- and stressor-related disorders (TSRD) are debilitating mental health conditions. Given the barriers to traditional services, remote and online technologies are increasingly used in treating TSRD.

Aims: This mixed-methods systematic review aimed to identify remote technologies and assessed their feasibility and acceptability in treating adults with post-traumatic stress disorder (PTSD), acute stress disorder and adjustment disorder (AjD).

Method: The databases MEDLINE, CINAHL, Embase, PsycInfo, PubMed and the Cochrane Library were screened to identify studies investigating the feasibility and acceptability of remote interventions for PTSD, acute stress disorder and AjD in adults. Studies that obtained poor-quality ratings on critical appraisal tools were excluded. Results were synthesised using a narrative review approach.

Results: In total, there were 74 studies evaluating 27 remote interventions for TSRD: online interventions (k = 47, 63.51%), mobile applications (k = 17, 22.97%), video conferencing (k = 9, 12.16%) and message-based systems (k = 1, 1.35%). Findings from the review showed higher feasibility and acceptability for interventions with an interactive clinician-patient component. Among self-directed interventions, only two applications and eight online interventions provided a clinician component. Most studies targeted PTSD, with few targeting other diagnoses.

Conclusions: Recommendations related to remote interventions for TSRDs should be broadened to include AjD and other underrepresented diagnoses, and tailored to individual patients' profiles, including their ability to sustain engagement and clinical needs, using a stepped-care approach.