Web-based interventions for traumatized people in mainland China

The Internet is now becoming a new channel for delivering psychological interventions. This paper reported a first application of web-based intervention in mainland China. It first summarized primary barriers to mental health help-seeking behavior in Chinese society. Then, it introduced the current utilization of the Internet within mental health services in mainland China and discussed how the Internet would help to improve people's help-seeking behaviors. More importantly, it presented main empirical findings from a randomized controlled trial (RCT) which investigated the efficacy of a web-based self-help intervention program (Chinese My Trauma Recovery website, CMTR) for 103 urban and 93 rural traumatized Chinese persons. The data revealed that 59% urban and 97% rural participants completed the posttest. In the urban sample, data showed a significant group×time interaction in Posttraumatic Diagnostic Scale (PDS) scores (F1,88=7.65, <i>p</i>=0.007). CMTR reduced posttraumatic symptoms significantly with high effect size after intervention (F1,45=15.13, Cohen's <i>d</i>=0.81, <i>p</i>&lt;0.001) and the reduction was sustained over a 3-month follow-up (F1,45=17.29, Cohen's <i>d</i>=0.87, <i>p</i>&lt;0.001). In the rural sample, the group×time interaction was also significant in PDS scores (F1,91=5.35, <i>p</i>=0.02). Posttraumatic symptoms decreased significantly after intervention (F1,48=43.97, Cohen's <i>d</i>=1.34, <i>p</i>&lt;0.001) and during the follow-up period (F1,48=24.22, Cohen's <i>d</i>=0.99, <i>p</i>&lt;0.001). These findings give preliminary support for the short-term efficacy of CMTR in the two Chinese populations. Finally, some implications are given for the future application of web-based interventions for PTSD in mainland China.

当前，互联网正成为提供心理干预服务的全新渠道。本研究首次报道了基于网络的心理干预在中国大陆的应用实践。研究首先系统梳理了中国社会中民众寻求心理健康服务的主要阻碍因素，随后介绍了中国大陆心理健康服务领域当前的互联网应用现状，并探讨了互联网如何助力提升民众的心理健康求助行为意愿。更为重要的是，本研究披露了一项随机对照试验（randomized controlled trial, RCT）的核心实证结果：该试验针对103名城市创伤幸存者与93名农村创伤幸存者，评估了基于网络的自助干预项目——中文名为“我的创伤康复”网站（Chinese My Trauma Recovery, CMTR）的干预效果。数据显示，59%的城市参与者与97%的农村参与者完成了后测评估。在城市样本中，创伤诊断量表（Posttraumatic Diagnostic Scale, PDS）得分呈现显著的组别×时间交互效应（F(1,88)=7.65，p=0.007）；干预后，CMTR可显著降低创伤后症状，且效应量较高（F(1,45)=15.13，科恩d值=0.81，p<0.001），该症状缓解效果在3个月随访期内仍得以维持（F(1,45)=17.29，科恩d值=0.87，p<0.001）。在农村样本中，PDS得分同样存在显著的组别×时间交互效应（F(1,91)=5.35，p=0.02）；干预后，农村样本的创伤后症状显著降低（F(1,48)=43.97，科恩d值=1.34，p<0.001），且在随访期内该改善效果持续存在（F(1,48)=24.22，科恩d值=0.99，p<0.001）。上述研究结果为CMTR在两类中国人群中的短期干预效果提供了初步实证支持。最后，本研究针对创伤后应激障碍（Post-Traumatic Stress Disorder, PTSD）的网络干预在中国大陆的未来应用提出了相关启示。