Background Veterans have higher rates of PTSD and depression compared to the general population and experience substantial functional impairment. Impairment in social functioning has been a significant concern among Veterans, particularly rural Veterans, who have limited access to mental health care and are at risk for social isolation. https://www.selleckchem.com/products/tph104m.html Objective A mixed-method study was implemented to evaluate the feasibility and effectiveness of webSTAIR, a web-based skills training programme, paired with home-based telehealth sessions. It was hypothesized that the programme would lead not only to reductions in PTSD and depression but also to improvements in social functioning. Method Participants were 80 trauma-exposed Veterans enrolled in rural-serving VHA facilities with clinically elevated symptoms of either PTSD or depression. The study directed substantial outreach efforts to rural women Veterans and those who have experienced military sexual trauma (MST). Results Significant improvements were obtained with PTSD and depression symptoms as well as in social functioning, emotion regulation, and interpersonal problems at post-treatment and 3-month follow-up. Ratings of therapeutic alliance were high as were reports of overall satisfaction in the programme. There were no differences by gender or MST status in symptom outcomes or satisfaction. Conclusions The results support the feasibility and effectiveness of this integrated telehealth web-based skills training programme for both male and female Veterans as well as for those with and without MST. The focus on resource building and improved functioning make this programme of particular interest. Further testing is warranted.Background Home-based psychotherapy delivered via telehealth has not been investigated in the context of intensive trauma-focused treatment for individuals with severe or Complex posttraumatic stress disorder (PTSD). Objective To examine the feasibility, safety and effectiveness of an intensive treatment programme containing prolonged exposure, EMDR therapy, physical activities and psycho-education, delivered via home-based telehealth. Method The treatment was carried out within four consecutive days during the outbreak of the COVID-19 pandemic. The sample consisted of six (four female) patients suffering from severe or Complex PTSD resulting from exposure to multiple traumatic events, mostly during early childhood. Four of them fulfilled the diagnostic criteria of complex PTSD. Outcome measures were the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), the PTSD Checklist for DSM-5 (PCL-5), and the International Trauma Questionnaire (ITQ). Results CAPS-5 and PCL-5 scores decreased significantly from pre- to post-treatment (Cohen's ds 1.04 and 0.93), and from post-treatment to follow-up (Cohen's ds 0.92 and 1.24). Four of the six patients lost their PTSD or Complex PTSD diagnostic status. No patient dropped out, no personal adverse events and no reliable symptom worsening occurred. Conclusions The results suggest that intensive, trauma-focused treatment of severe or Complex PTSD delivered via home-based telehealth is feasible, safe and effective, and can be a viable alternative to face-to-face delivered intensive trauma-focused treatment.Individual differences in the response to trauma are influenced by numerous contextual factors such as one's cultural background, the environment in which trauma occurs, the meanings attached to traumatic experiences, and various other social and cultural determinants both before and after traumatic exposure. This special issue of the European Journal of Psychotraumatology presents a series of papers conducted as part of the Collaborative Network for Training and Excellence in Psychotraumatology (CONTEXT); a programme of research which seeks to advance our understanding of the impact of trauma within diverse populations who are highly trauma exposed. Applying a context-specific focus, CONTEXT prioritised working closely with service users and those organisations delivering critical support in the wake of trauma exposure. The seven papers presented in this special issue are divided into those who are exposed to trauma either (i) directly (survivors of childhood adversity in the USA; LGB youth in Northern Ireland; refugees and asylum seekers in the EU; and members of the general population exposed to conflict in Israel) or (ii) vicariously (fire fighters in the UK, humanitarian aid volunteers in Sudan, and child protection workers in Denmark). Together, findings from these studies demonstrate that social support, in its many different forms, is a universally important factor in the response to trauma. We discuss how traumatic stress can be compounded when, and can thrive within, contexts where necessary social support is absent or inadequate. We also emphasize the importance of recognizing the context specificity of trauma exposure and trauma response, as well as the need for collaboration between psychotrauma researchers and organisations who deliver support to traumatized populations to ensure rapid and effective translation of research findings into practice.Background Despite growing support for the distinction between posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) as separate diagnoses within the ICD-11 psychiatric taxonomy, the prevalence and treatment implications of CPTSD among current and ex-serving military members have not been established. Objective The study aims were to a) establish the prevalence of provisional ICD-11 CPTSD diagnosis relative to PTSD in an Australian sample of treatment-seeking current and ex-serving military members, and b) examine the implications of CPTSD diagnosis for intake profile and treatment response. Methods The study analysed data collected routinely from Australian-accredited treatment programmes for military-related PTSD. Participants were 480 current and ex-serving military members in this programmes who received a provisional ICD-11 diagnosis of PTSD or CPTSD at intake using proxy measures. Measures of PTSD symptoms, disturbances in self-organisation, psychological distress, mental health and social relationships were considered at treatment intake, discharge, and 3-month follow-up.