Helpful but Not Enough: Exploring Participants' Experiences of a Digital Therapist-guided Prolonged Exposure Treatment for PTSD

Post-traumatic stress disorder (PTSD) can be a severe psychiatric condition, and access to timely evidence-based treatment is often limited. Prolonged exposure is recommended as first line treatment in clinical guidelines. There is limited research on how digital formats of prolonged exposure used to increase treatment availability impact user experience. Therefore, we wanted to investigate patients' experiences of prolonged exposure in a therapist-guided internet-delivered format (HOPE; Huddinge Online Prolonged Exposure), as part of an uncontrolled feasibility study. Semi-structured interviews were conducted with a total of 14 participants upon their completion of HOPE. Thematic analysis revealed that participants found HOPE to be helpful and effective, especially valuing the flexibility in the digital treatment format. However, a subset of participants reported that HOPE did not meet their needs entirely, indicating room for improvement and tailoring of treatment to individual preferences and needs. This study represents the first exploration of internet-delivered prolonged exposure therapy within a Swedish psychiatric setting, comprising participants characterized by moderate to severe PTSD and self-rated complex PTSD. The results could help guide the development of more accessible and acceptable treatments for PTSD, ultimately improving treatment quality.