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Computerised CBT PTSD Exclusions — MRCPsych Paper B MCQ

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ModerateAnxiety & Stress-Related DisordersComputerised CBT PTSD ExclusionsMRCPsych Paper B

An adult with PTSD presents 6 months after the traumatic event and prefers supported trauma-focused computerised CBT to face-to-face trauma-focused CBT or EMDR. Which feature would mean that the NICE criteria for considering this intervention are not met?

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Correct answer: E — Severe PTSD symptoms, particularly dissociative symptoms, or risk of harm to self or others

NICE recommends considering supported trauma-focused computerised CBT for adults who present more than 3 months after trauma and prefer it to face-to-face trauma-focused CBT or EMDR, provided that they do not have severe PTSD symptoms—particularly dissociative symptoms—and are not at risk of harming themselves or others. Therefore, B falls outside the recommended eligibility criteria. Mild symptoms without dissociation or risk do not exclude treatment. A formal PTSD diagnosis is not essential because clinically important PTSD symptoms can also qualify. Preference for computerised therapy and presentation beyond 3 months are factors supporting consideration of the intervention rather than reasons to exclude it.

Reference: National Institute for Health and Care Excellence. Post-traumatic stress disorder (NG116), recommendation 1.6.21: supported trauma-focused computerised CBT. 2018, current following April 2025 surveillance. https://www.nice.org.uk/guidance/ng116/chapter/recommendations