Spring for post traumatic stress disorder (PTSD)
Spring PTSD is an eight-step guided digital therapy for the treatment of post-traumatic stress disorder (PTSD) related to a single traumatic event.
Based on cognitive behavioural therapy with a trauma focus (CBT-TF), Spring PTSD was developed and refined in collaboration with individuals with lived experience of PTSD and leading experts in the field.
The approach aims to reduce the need for extensive therapist contact by delivering evidence-based therapeutic techniques and activities digitally, with regular guidance and support from a therapist.
Programme structure
The eight steps cover:
Step 1: Learning about my PTSD
This introductory step provides an overview of PTSD, featuring five actors who portray characters sharing their personal experiences related to different types of traumatic events.
Step 2: Grounding myself
Participants learn about grounding techniques and their benefits. This step includes practical demonstrations of exercises designed to help individuals stay connected to the present moment and manage distressing emotions.
Step 3: Managing my anxiety
This step teaches relaxation techniques through guided video demonstrations. Participants are introduced to controlled breathing, progressive muscle relaxation, and imagery-based exercises to help manage anxiety.
Step 4: Reclaiming my life
This step focuses on behavioural activation, guiding participants to gradually resume activities they once enjoyed or explore new ones. It encourages them to take small, manageable steps towards rebuilding their lives.
Step 5: Coming to terms with my trauma
This step introduces imaginal exposure therapy. The therapist guides participants in beginning their own trauma narratives, which they continue to develop on their own. Participants are encouraged to engage with these narratives by reading them for at least 30 minutes each day.
Step 6: Changing my thoughts
Cognitive techniques are introduced to help participants challenge and reframe unhelpful thoughts related to their trauma.
Step 7: Overcoming my avoidance
A structured approach to gradually confront and reduce avoidance of real-life situations associated with the trauma.
Step 8: Keeping myself well
This final session reinforces lessons learned throughout the programme, offering relapse prevention strategies and guidance on managing any recurrence of symptoms.
Features
- Interactive content: Each step is accompanied by audio narration, with key information and visuals displayed on screen. Participants’ input directly influences the feedback they receive, and branching screens allow for flexible navigation. A bookmarking feature ensures users can easily return to where they left off.
- Character case studies: The programme features five characters, each portrayed by actors, representing individuals with PTSD after different traumatic events. Video content tracks their progress through each step, providing relatable examples of how individuals might navigate Spring PTSD.
- Toolkit: A dedicated area provides easy access to key programme components and information input by users. The tools support engagement with CBT-TF techniques, such as building a fear-ladder and writing a detailed trauma narrative.
- Clinician Dashboard: The clinician dashboard provides therapists with real-time data on participant engagement and progress through the programme. This data allows therapists to tailor their support during guidance sessions, addressing specific needs and ensuring participants stay on track with the digital materials.
- Information for family and friends: A helpful leaflet is available for family and friends, providing information on PTSD and an overview of the Spring PTSD programme. This resource helps loved ones better understand the condition and learn how to support the participant during treatment.
Therapist guidance
- Initial meeting: A one-hour introductory session with a therapist helps establish rapport, assess the participant’s trauma history, provide login details, and offer a full demonstration of the programme.
- Follow-up sessions: Four bi-weekly meetings, each lasting 30 minutes, offer continuous support to participants, helping them remain engaged and effectively tackle any challenges they may face.
- Ongoing support: In addition to the meetings, participants receive four brief check-ins by phone or email between sessions to discuss their progress, resolve issues, and set new goals.
- Therapist manual: A comprehensive therapist manual ensures the programme can be delivered in a standardised and structured way. It provides detailed instructions and guidelines, enabling therapists to deliver Spring PTSD consistently and effectively.
Accessibility
The Spring programme is designed for use on various devices, including PCs, laptops, tablets, and smart phones.
Supporting evidence for the use of Spring PTSD
Publications
Lewis, C., Roberts, N.R., Vick, and Bisson J.I. (2013) Development of a guided self-help (GSH) program for the treatment of mild to moderate post-traumatic stress disorder (PTSD) Depression and Anxiety; 30 (11): 1121 – 1128.
Lewis, C.et al. 2017. Internet-based guided self-help for post-traumatic stress disorder (PTSD): randomised controlled trial. Depression and Anxiety 34(6), pp. 555-565.
Bisson, J. I. et al. 2022. Guided, internet based, cognitive behavioural therapy for post-traumatic stress disorder: pragmatic, multicentre, randomised controlled non-inferiority trial (RAPID). BMJ 377, article number: e069405. (10.1136/bmj-2021-069405)
Simon, N. et al. 2021. Internet-based psychological therapies: a qualitative study of National Health Service commissioners and managers views. Psychology and Psychotherapy: Theory, Research and Practice 94(4), pp. 994-1014.
Simon, N. et al. 2023. The acceptability of a guided internet-based trauma-focused self-help programme (Spring) for post-traumatic stress disorder (PTSD). European Journal of Psychotraumatology 14(2), article number: 2212554.
Lewis, C., Bailey, L., Ariti, C., Kitchiner, N. J., Robertson, N. P., Simon, N. and Bisson, J. I. 2023. Social support as a predictor of outcomes of cognitive behavioral therapy with a trauma focus delivered face-to-face and via guided internet-based self-help. Journal of Traumatic Stress 36(3), pp. 511-523. (10.1002/jts.22947)
Videos
RAPID: can guided self-help be as effective in treating PTSD? – YouTube