Contact: Michiyo Hirai, WSU Department of Psychology, 509/335-2802, hiraim@wsu.edu
Internet-based Program Offers Help for Traumatic Stress
PULLMAN, Wash. -- The Internet has become a primary source for people seeking health information. But could it serve as a useful source of therapy as well?
Michiyo Hirai, an assistant professor of psychology at
Washington State University, and her co-author George A. Clum of
Virginia Tech, have created an Internet-based program that offers
promise in treating people suffering from psychological distress
related to traumatic events in their lives. They reported their
findings in a recent edition of the Journal of Traumatic
Stress.
Hirai, who earned her doctoral degree from Virginia Tech where Clum
was her dissertation advisor, said that an Internet-based approach
"has a lot of potential to provide therapy to people who lack
access to conventional treatment," including people in rural areas
far from available mental-health resources, as well as those who
are uncomfortable with or can't afford one-on-one therapy.
"There may be people who are experiencing relatively mild symptoms,
but still want to find a solution to their problem because they
feel that it is a significant impairment," said Hirai.
In her research, Hirai worked with people who had been in serious
car accidents, had been victims of violence, had survived a
life-threatening disease, had witnessed a violent event or had lost
a close relative through suicide or murder. While they did not
display symptoms as severe as people with the most serious forms of
post-traumatic stress disorder, they did show a range of problems
including sleeplessness, bad dreams, depression and anxiety.
The eight-week cognitive-behavioral treatment program is structured
in four modules, progressing in difficulty. An on-line exam at the
end of each module tests mastery of the material.
The first module provides basic information about traumatic stress
and its treatment. The second moves into relaxation training. The
third deals with cognitive restructuring, a process that helps
people learn to recognize automatic negative thoughts and evaluate
and modify thought processes that lead to anxiety and emotional
distress.
The fourth, and most difficult, attempts to take subjects back
through the traumatic event. People who have experienced such an
event often go to great lengths to avoid similar, anxiety-provoking
situations. A major factor preventing recovery from the effects of
trauma is avoidance of memories, thoughts, feelings and situations
associated with the traumatic event. Avoidance increases the
likelihood that the person will continue to re-experience aspects
of the trauma in flashbacks or nightmares.
Confronting the traumatic experiences -- exposure - allows
sufferers to reduce such problems. However, "simply telling
sufferers to expose themselves to a fear-producing situation
doesn't work," Hirai said, citing an example of a person who has
been in a serious car accident being unable to get back into a car,
or to travel through the area where the accident occurred.
In Hirai's Internet-based program, subjects are asked to write a detailed account of the traumatic event and how they reacted to it. Then, they are asked to read their account repeatedly until they become more comfortable with the event and the feelings it creates.
Hirai's research found that people who completed the program showed significant improvement in coping skills, depression and anxiety levels when compared to people in a control group.
She said she has not yet pursued any possible commercial applications of her work. She has received a grant through the WSU seed grant program and will use that money to support her efforts to tailor the on-line therapy tool to treat victims of sexual assault.
Hirai, who was born and raised in Tokyo, joined the faculty at WSU in August 2004.