Group Written Exposure Therapy for PTSD

(GWET Trial)

Overseen By Jenna Boyd, Ph.D.

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: St. Joseph's Healthcare Hamilton

Disqualifiers: Severe SUD, Psychotic disorder, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 2 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 6

Duration: 6 weeks

63 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests the effectiveness of Written Exposure Therapy (WET) in a group setting for individuals with post-traumatic stress disorder (PTSD). It aims to determine if group WET reduces PTSD symptoms and results in fewer dropouts compared to Cognitive Processing Therapy (CPT). Participants will attend six online group sessions led by therapists and will report on their symptoms throughout the trial. Individuals with PTSD who can read and write in English may qualify, but those with certain mental health conditions or recent self-harm attempts are not eligible. The study will compare symptom changes over time between group WET and group CPT. As an unphased trial, it offers participants the chance to contribute to innovative research that could enhance PTSD treatment options.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What prior data suggests that group Written Exposure Therapy is safe for PTSD patients?

Research shows that Written Exposure Therapy (WET) is generally safe and effective for treating PTSD. Studies indicate that even individuals with complex PTSD and other mental health issues respond well to WET. An initial study found that using WET in a group setting was practical and promising for reducing PTSD and depression symptoms. These studies reported no major negative effects, suggesting the therapy's safety for participants. Overall, increasing evidence supports WET's safety and effectiveness for treating PTSD. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Unlike traditional PTSD treatments like cognitive behavioral therapy (CBT) or medication, Group Written Exposure Therapy offers a unique approach by focusing on structured writing exercises in a group setting. Researchers are excited about this method because it encourages patients to process traumatic experiences through writing, which can be less intimidating than verbal therapy. Additionally, this therapy can be more accessible and cost-effective since it can be conducted in groups, potentially reaching more individuals in need.

What evidence suggests that Group Written Exposure Therapy might be an effective treatment for PTSD?

Research has shown that Written Exposure Therapy (WET) effectively treats PTSD. Studies have found that WET can reduce symptoms even in individuals with complex cases and other mental health issues. Evidence suggests that WET is practical due to its brief format of only five sessions, making it accessible to more people in need. Compared to other treatments, WET has successfully improved PTSD symptoms across various patient groups. It is considered a good option for those seeking a quick and effective PTSD treatment. ^{1 2 6 7 8}

Who Is on the Research Team?

Jenna Boyd, Ph.D.

Principal Investigator

St. Joseph's Healthcare Hamilton

Are You a Good Fit for This Trial?

This trial is for adults aged 18-65 with PTSD who can read and write in English. They must be able to give informed consent. It's not clear what excludes someone from participating, but typically it would involve factors that could interfere with the treatment or data collection.

Inclusion Criteria

I have been diagnosed with PTSD.

Able to provide written informed consent and can read and write in English

Exclusion Criteria

Untreated active psychotic, manic or hypomanic symptoms

Diagnosis of an active severe substance use disorder (SUD)

Has engaged in high-risk self-harm (e.g., cutting, burning, asphyxiation) in the 2 months prior to beginning treatment

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants attend 6 weekly sessions of group Written Exposure Therapy (WET) delivered online by two therapists

6 weeks

6 visits (virtual)

Follow-up

Participants are monitored for changes in PTSD symptoms and related measures at 1-month post-treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Group Written Exposure Therapy

Trial Overview The trial tests Group Written Exposure Therapy (WET) for PTSD, comparing its effectiveness and dropout rates against group Cognitive Processing Therapy (CPT). Participants will attend six weekly online sessions led by therapists and complete symptom questionnaires over time.

How Is the Trial Designed?

Group I: Group Written Exposure Therapy Experimental Treatment 1 Intervention

Patients will be invited to participate in group Written Exposure Therapy (described in the "Interventions" section).

Group Written Exposure Therapy is already approved in United States, European Union for the following indications:

Approved in United States as Written Exposure Therapy for:

• Posttraumatic Stress Disorder (PTSD)

Approved in European Union as Written Exposure Therapy for:

• Posttraumatic Stress Disorder (PTSD)

Who Is Running the Clinical Trial?

St. Joseph's Healthcare Hamilton

Lead Sponsor

Trials

203

Recruited

26,900+

Published Research Related to This Trial

Written Exposure Therapy (WET) is an effective 5-session treatment for PTSD that shows significant symptom improvement and requires less time from both patients and therapists compared to traditional therapies.

WET has similar efficacy to Cognitive Processing Therapy (CPT) but with a much lower dropout rate (6% for WET vs. 39% for CPT), making it a promising option for diverse populations, including veterans.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Brief novel therapies for PTSD: Written Exposure Therapy. Thompson-Hollands, J., Marx, BP., Sloan, DM.[2022]

Written exposure therapy (WET) was found to be noninferior to prolonged exposure therapy (PE) in reducing PTSD symptoms among 178 veterans, demonstrating similar effectiveness with fewer sessions required.

Participants in the WET group had significantly lower dropout rates (12.5%) compared to those in the PE group (35.6%), suggesting that WET may be a more accessible treatment option for PTSD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Written Exposure Therapy vs Prolonged Exposure Therapy in the Treatment of Posttraumatic Stress Disorder: A Randomized Clinical Trial. Sloan, DM., Marx, BP., Acierno, R., et al.[2023]

Written exposure therapy (WET) significantly reduced PTSD symptoms in Korean patients, with 60.9% of participants no longer meeting PTSD criteria at 6 weeks, increasing to 77.8% at 24 weeks, demonstrating its efficacy.

The therapy also improved depressive symptoms and global functioning, with a low dropout rate of 8%, indicating that WET is a feasible and effective treatment option for PTSD in diverse populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An Open Pilot Trial of Written Exposure Therapy for Patients With Post-Traumatic Stress Disorder in Korea. Park, JE., Choi, KS., Han, YR., et al.[2021]

Written exposure therapy, a brief 5-session intervention, was found to be noninferior to the more intensive cognitive processing therapy in treating PTSD among military service members, indicating it can be an effective alternative.

The study involved 169 active-duty military participants, with a high completion rate of 76.5% for written exposure therapy, suggesting it may be a more efficient treatment option with lower dropout rates.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of Written Exposure Therapy vs Cognitive Processing Therapy on Increasing Treatment Efficiency Among Military Service Members With Posttraumatic Stress Disorder: A Randomized Noninferiority Trial. Sloan, DM., Marx, BP., Resick, PA., et al.[2022]

Written Exposure Therapy (WET) is as effective as Cognitive Processing Therapy (CPT) for treating PTSD, maintaining similar outcomes even 60 weeks after treatment, with large effects on PTSD symptoms for both therapies.

Both WET and CPT significantly reduced depressive symptoms over the study period, although CPT showed a quicker reduction; however, the overall difference in effectiveness for depression was small.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Long-term treatment gains of a brief exposure-based treatment for PTSD. Thompson-Hollands, J., Marx, BP., Lee, DJ., et al.[2022]

Written Exposure Therapy (WET) significantly reduced PTSD symptoms (effect size d = .84), depression symptoms (d = .47), and functional impairment (d = .36) in a study involving 277 veterans, demonstrating its effectiveness in a clinical setting.

The treatment was effective regardless of whether it was delivered in-person or via telehealth, with telehealth showing a lower dropout rate, suggesting it may be a more accessible option for patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of written exposure therapy for posttraumatic stress disorder in the Department of Veterans Affairs Healthcare System. LoSavio, ST., Worley, CB., Aajmain, ST., et al.[2023]

Written exposure therapy (WET) is as effective as cognitive processing therapy (CPT) in treating PTSD, showing noninferior symptom reduction over time in a study of 126 participants.

WET requires significantly fewer sessions (5 sessions) compared to CPT (12 sessions) and resulted in lower dropout rates, suggesting it may be a more efficient treatment option for patients with PTSD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Brief Exposure-Based Treatment vs Cognitive Processing Therapy for Posttraumatic Stress Disorder: A Randomized Noninferiority Clinical Trial. Sloan, DM., Marx, BP., Lee, DJ., et al.[2022]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11809123/

A pilot study of twice-weekly group-based written exposure ... Findings demonstrate that brief, group-delivered WET is feasible and shows promise for addressing PTSD and depressive symptoms in residential SUD treatment.

2. ptsd.va.gov ptsd.va.gov/professional/treat/txessentials/written_exposure_therapy.asp

Written Exposure Therapy for PTSD - PTSD: National ... A growing number of studies indicate that WET is effective for PTSD, even among patients with complicated presentations and other comorbid disorders.

3. jamanetwork.com jamanetwork.com/journals/jamapsychiatry/fullarticle/2808302

Written Exposure Therapy vs Prolonged ... These findings suggest that WET is a viable option for PTSD treatment and has the potential to reach a greater number of individuals who are in need of PTSD ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6168424/

Long-Term Treatment Gains of a Brief Exposure-Based ... Written exposure therapy (WET) is a 5-session PTSD treatment that may address barriers in treatment for posttraumatic stress disorder (PTSD) given its brevity ...

5. ptsd.va.gov ptsd.va.gov/professional/articles/article-pdf/id1582525.pdf

Effectiveness of Written Exposure Therapy for ... Conclusions: WET was an effective approach across a range of patient characteristics in this sample of veterans with PTSD. WET was also effective whether ...

6. clinicaltrials.gov clinicaltrials.gov/study/NCT05553249

Written Exposure Therapy for PTSD in a Virtual, Group ... It identifies the role of the intervention that participants receive. Types of arms include experimental arm, active comparator arm, placebo comparator arm, ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8079278/

Comparing written exposure therapy to ... - PubMed Central In an ongoing randomized controlled trial (RCT) we are investigating whether WET is non-inferior in treating PTSD compared with the more time intensive PE.

8. sciencedirect.com sciencedirect.com/science/article/pii/S2666560323000713

Supporting the implementation of written exposure therapy ... This paper presents implementation process outcomes of Written Exposure Therapy (WET), a brief, scalable, and sustainable evidence-based PTSD treatment ...