Trauma-focused guided self-help (TF-GSH) is an important alternative to psychological therapy delivered by a therapist. This meta-analysis evaluates the efficacy of TF-GSH in reducing posttraumatic stress disorder (PTSD) symptoms and comorbid depressive and anxiety symptoms. A total of 17 trials were included that compared a TF-GSH intervention (N = 610) to various control comparators (N = 570). Control conditions included treatment as usual (k = 2), waiting list (k = 11), phone monitoring (k = 1), nontrauma writing (k = 1), general support (k = 1), and supportive counseling (k = 1). A moderate- to large-sized effect favouring TF-GSH was observed for PTSD (k = 17, g = −0.81, 95% confidence interval [CI]: −1.24, −0.39) and a moderate-sized effect was observed for depressive (k = 13, g = −0.73, 95% CI: −1.16, −0.31) and anxiety (k = 11, g = −0.72, 95% CI: −1.18, −0.27) symptoms, with considerable heterogeneity. Moderator analyses were all not statistically significant. Results indicate that TF-GSH is a promising treatment for PTSD and comorbid depressive and anxiety symptoms. We discuss the nature, extent, and quality of the literature to provide a point of departure for future research. TF-GSH (and unguided self-help) may not be appropriate for certain individuals at certain times. Exploring a broad range of treatment delivery modalities will move the field closer towards a model of evidence-based care in which the likely appropriate dose and type of intervention can be matched to individuals based on presenting problems and other variables.

中文翻译：

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针对创伤后应激障碍的以创伤为中心的引导式自助干预：随机对照试验的荟萃分析

以创伤为中心的引导式自助 (TF-GSH) 是治疗师提供的心理治疗的重要替代方法。该荟萃分析评估了 TF-GSH 在减少创伤后应激障碍 (PTSD) 症状以及共病抑郁和焦虑症状方面的功效。总共包括 17 项试验，将 TF-GSH 干预（N  = 610）与各种对照比较（N  = 570）进行比较。控制条件包括照常治疗 ( k  = 2)、等候名单 ( k  = 11)、电话监控 ( k  = 1)、非创伤性写作 ( k  = 1)、一般支持 ( k  = 1) 和支持性咨询 ( k = 1). 对于 PTSD（k  = 17，g  = -0.81，95% 置信区间 [CI]：-1.24，-0.39）观察到有利于 TF-GSH 的中等到大型效应，对于抑郁症观察到中等规模的效应( k  = 13, g  = −0.73, 95% CI: −1.16, −0.31) 和焦虑 ( k  = 11, g = −0.72, 95% CI: −1.18, −0.27) 症状，具有相当大的异质性。主持人分析均无统计学意义。结果表明，TF-GSH 是治疗 PTSD 和共病抑郁和焦虑症状的一种有前途的治疗方法。我们讨论文献的性质、范围和质量，为未来的研究提供一个出发点。TF-GSH（和无指导的自助）在某些时候可能不适合某些人。探索广泛的治疗提供方式将使该领域更接近循证护理模型，在该模型中，可以根据存在的问题和其他变量将可能适当的干预剂量和类型与个体相匹配。