# Transcript

[MUSIC PLAYING]
SARAH COSGROVE
So I met with the team at Cardiff University, and we had to go through a bit of a process to see if I was suitable. So was it one single event that caused my PTSD? Yes, it was. And was I prepared to put the hard yards in and do this work myself, which I was more than prepared to do, because I wanted to stop being a victim and be active in my recovery and get back.
NEIL ROBERTS
So PTSD is a serious mental health disorder that can develop for some people through exposure to very threatening events or traumas. Standard therapy for PTSD would normally involve appointments that last 60 to 90 minutes over around three months. I guess the difference with guided self-help is that a lot of the work that service users would do is self-directed. So we've developed a package that takes them through a number of steps.
SARAH COSGROVE
When I told my family that I would be going on to this trial using an app, they were a bit worried about doing everything remotely with no support. But I was very supported. I would meet regularly with a therapist, either in person or on the telephone. And that would happen at least weekly. But the app was particularly good at illustrating what PTSD can mean in a civilian context. It helped me learn about my PTSD, and it helped me understand that what I was experiencing was totally normal. So things like heightened anxiety, palpitations, getting very hot, perspiring, breathless, all of those things were explored in the app. And so it was great, because I was able to realise that this is normal, and this is what having this condition means.
NEIL ROBERTS
The appointments are briefer, and the focus for the therapist is more on ensuring that the service user is engaged with the programme. It's a different way of working. So normally we would-- I guess relationship building is an important part of the therapy process and trying to help.
SARAH COSGROVE
So there are tips like how to ground yourself. They are basically techniques to bring you into the moment to stop your mind from going back and reliving that traumatic event over and over. One of the major symptoms of my PTSD was anxiety. And the app was really good at giving me ways, techniques to manage my anxiety. And slowly I was able to enjoy socialising again.
I'd also always wanted a dog, and we got a dog. And that was a fantastic thing to do. So the app guides you to a point where you need to come to terms with your trauma. And it takes the form of writing a present-tense, very detailed account of what that trauma was. And then you read it. And you read it over and over and over and over again, until eventually you become desensitised to it. And I think really that was one of the most powerful steps in the app.
And so because I was guided by the therapists, they were meeting me regularly, I felt confident enough to take those steps, that if I was feeling particularly anxious or traumatised again, that I could talk it over with them. The app gets you to write a letter to a friend as if that friend was you. And so you're able to take an external perspective. And I find that hugely helpful, actually. The talking sessions are brilliant. So if you are feeling a bit uncertain or you're having a bit of a wobble, you know that you've got that added reassurance of talking to a real-life human being.
The flexibility of the app is really wonderful, because you have it when you need it. So if I was having a moment, I could just reach into my pocket, get out my phone, and bring it up. But also I didn't have to take loads of time off for medical appointments. I could do the preparatory work from my own home. I could do it when my daughter was in bed. I could do it on the weekends. And so again, it was a really important way to help me get control back, because I was at the heart of that recovery.
NEIL ROBERTS
We don't know at the moment if this is the right intervention for everyone. I think we know clinically that people with more complex presentations, with more severe symptoms will probably need longer interventions and probably also the direct face-to-face nature of standard therapy.
CATRIN LEWIS
The guidelines in the United Kingdom say that we should be using psychological therapy rather than medication. The only problem is that we have very long waiting lists to access psychological therapy. And unfortunately, there are a limited number of therapists that are able to deliver these sorts of interventions, as we know. And technology is evolving. And it's very important for interventions of this sort to keep up with technology and to be able to be used on the latest devices and so forth.
So for example, here in Wales we have individuals that live in rural, remote areas that simply aren't able to access psychological therapies. So these sorts of interventions enable the opportunity for people that wouldn't normally be able to get access to psychological therapies to engage in treatment such as this. But we're still undergoing clinical trials to try and establish enough evidence in order that it can be used routinely at the NHS. But the trial that we have ongoing at the moment is actually a multisite trial. So we're testing it here in Wales, but also in England and in Scotland. And we're hoping that the results will support our ongoing work.