RAPID

The study

RAPID was a pragmatic randomised controlled trial of a trauma-focused guided self-help programme versus Individual Trauma-Focused Cognitive Behavioural Therapy for Post-Traumatic Stress Disorder

RAPID has centres in England, Scotland and Wales.

It aimed to determine if trauma-focused guided self-help (GSH), using a web-based programme called ‘Spring’, provides a faster and more cost-effective treatment for Post-Traumatic Stress Disorder (PTSD), than individual trauma-focused cognitive behavioural therapy (TFCBT), whilst being equally clinically effective.

The RAPID trial ended in January 2020.

PTSD Treatment

Evidence suggests that the most effective psychological approaches to treat PTSD are those that are based on trauma-focused cognitive behavioural therapy (TFCBT), including trauma-focused cognitive therapy, and eye movement desensitization and reprocessing therapy (EMDR).

However, there are a limited number of suitably qualified therapists able to deliver these interventions and waiting lists can be very long.

Another potential barrier to treatment is the required commitment from individuals to attend regular appointments in person over several months, which might be difficult for many reasons, such as taking time off work, childcare commitments, and perhaps a perceived stigma about attending mental health services.

Guided Self-Help (GSH)

GSH is a form of treatment that combines regular guidance from a therapist with self-help materials, which can be accessed by patients in a flexible way at their convenience.

This treatment type generally demands less therapist time and may be a solution in the treatment for PTSD, potentially reducing waiting times. Building on promising results from earlier Phase I and Phase II work, RAPID has been funded by the National Institute for Health Research (NIHR).

The GSH programme being tested in RAPID, ‘Spring’, has been developed by Cardiff University’s Traumatic Stress Research Group and Healthcare Learning Company, informed by people with lived experience of PTSD and health professionals working with PTSD.

It is an eight-step online programme that takes users through information about PTSD and typical symptoms, unlocking helpful tools and techniques for symptom management.

Therapists guide and support RAPID participants through ‘Spring’, encouraging access to the programme and completion of homework.

Outcomes

192 participants were randomly allocated to receive either face-to-face Trauma-Focused Cognitive Behaviour Therapy (TFCBT) or Trauma-Focused online Guided Self Help (GSH).

Trial outcomes include measures of PTSD, depression, anxiety, insomnia, self-efficacy, quality of life, disability.

Outcome measurements were taken at 16 weeks and 52 weeks post-randomisation.

Information was collected to estimate the costs of delivering the GSH, and to evaluate whether it is successful and acceptable from the perspective of the patient, their family, the health service and society.

Public Involvement in RAPID

Individuals with lived-experience of PTSD have been involved in the development of RAPID in the following ways:

Involved as co-applicants on the grant application.
Reviewing ‘Spring’, the RAPID Guided Self-Help programme.
RAPID Trial Management representation
RAPID PPI Group membership

“I am certain that if a self-help programme, such as the Spring Programme, had been made available to me immediately after that traumatic event, many years of suffering would have been prevented.”
Pauline Taylor (Patient representative)

The RAPID trial ended in January 2020.