An Internet-Based Self-Change Program for Trauma Sequelae

The purpose of this study was to examine whether a newly developed Internet-based, eight-week self-change program, Self-Help Intervention Program for the Consequences of Trauma (SHICT), was effective to treat trauma consequences. The SHICT consisted of education, anxiety management skills, cognitive restructuring, and exposure modules that included writing exposure and in vivo exposure. It also provided a mastery approach where individuals begin treatment with the least anxiety-provoking component (i.e., relaxation) and progress to the most fearful component (i.e., exposure). This approach was employed to ensure that trauma victims learn and become skilled users of anxiety-reducing coping techniques and decrease the likelihood of untoward responses to writing exposure. Thirty-three participants were randomly assigned to either a SHICT condition or a wait-list condition and 27 completed participation. Trauma-related symptoms, state anxiety, depression, coping skills, social support, and self-efficacy were assessed at pre and post-treatment. Results indicated that overall the SHICT group reduced symptoms and increased coping skills more significantly than the control group. Particularly, individuals in the SHICT group decreased intensity and frequency of avoidance behavior, frequency of intrusion, state anxiety, and depression more significantly than those in the control group. The SHICT group also increased general coping skills and coping self-efficacy more significantly than the control group. The SHICT produced medium to large effect sizes in many symptom and coping-related measures. The SHICT group demonstrated more clinically significant improvement than the control group in several symptom and coping-related measures. Increased coping self-efficacy and perceived social support levels and decreased wishful thinking coping were significantly correlated with symptom improvement. Both exposure and cognitive skills mastery levels were significantly correlated with decreased intensity and frequency of avoidance behavior.