Perceptions and Experiences of Web-Prolonged Exposure for Posttraumatic Stress Disorder: A Mixed-Methods Study

Objective: Web-based prolonged exposure therapy (Web-PE) has potential to increase the reach of effective posttraumatic stress disorder (PTSD) treatment. While there is initial support for the efficacy of Web-PE, no studies have examined the perceptions and experiences of participants receiving PE in this novel, Web based format. Method: We used a mixed-methods convergent design to examine and integrate quantitative and qualitative data of participant perceptions and experiences of Web-PE. Treatment-seeking active duty military personnel or veterans (N = 29) who received Web-PE completed posttreatment surveys about perceptions of Web-PE and a brief qualitative interview. Thematic coding was used to identify qualitative themes, which were integrated with quantitative data in a joint display. Results: Although many were initially skeptical of experiencing benefit, participants reported that Web-PE was helpful. They appreciated the flexibility of online therapy and reported that self-motivation was important for engagement. Web-PE therapists were well-regarded, although additional therapist support and technical improvements to the Web-PE program were suggested. Scores on the perceptions of Web-PE survey, PTSD survey, and other quantitative data corroborated the qualitative themes. Conclusion: Perceptions and experience of Web-PE are favorable and help to highlight the strengths (e.g., flexibility) and challenges (e.g., requiring self-motivation) associated with Web-treatment for PTSD. The results of this study may inform further development of Web-PE or other Web-based treatment programs. Clinical Impact Statement Participants who received a Web-based version of prolonged exposure (Web-PE) therapy for posttraumatic stress disorder (PTSD) found the program helpful. They valued having expert therapists facilitating the program and appreciated being able to do treatment at home. They felt that high motivation was needed to complete the program, and they suggested program improvements. Given that in-person PTSD treatment is not widely available, Web based programs such as Web-PE can increase access to effective PTSD care.