Virtual Trauma Support for Autistic Adults with PTSD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Wyoming

Disqualifiers: Non-autistic, English comprehension, trauma therapy, others

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

Compensation: Varies

Number of Visits: 9

Duration: 5 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to test a virtual therapy called Written Exposure Therapy (WET) to help autistic adults with PTSD (post-traumatic stress disorder) symptoms. Researchers seek to determine if this therapy can reduce PTSD symptoms and improve health measures like sleep and activity. Participants will wear a Fitbit and join weekly online sessions to track their progress. This trial suits autistic adults who have experienced trauma and seek help for ongoing stress symptoms.

As an unphased trial, participants can contribute to innovative research that could shape future PTSD therapies.

Do I have to stop taking my current medications to join the trial?

The trial protocol does not specify whether you need to stop taking your current medications. However, it does exclude participants who are currently receiving trauma-focused therapeutic services.

What prior data suggests that this protocol is safe for autistic adults with PTSD?

Research shows that Written Exposure Therapy (WET) is generally manageable for participants. It involves writing about difficult experiences over five sessions, which can help reduce symptoms of posttraumatic stress disorder (PTSD). In previous studies, participants reported feeling more at ease and less anxious over time. Few major side effects have been reported, suggesting WET is safe for most people. However, individual experiences can vary. Participants should discuss any concerns with the study team or a healthcare provider. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Written Exposure Therapy (WET) is unique because it offers a new approach to treating PTSD in autistic adults through telehealth. Unlike traditional PTSD treatments that often require in-person sessions, WET provides a convenient remote option, making therapy more accessible. Researchers are excited about this treatment because it simplifies the therapy process by focusing on writing exercises, which can be less intimidating and more manageable for individuals with autism. This method not only removes barriers associated with travel and social interaction but also harnesses the therapeutic power of structured, expressive writing to help process traumatic experiences.

What evidence suggests that Written Exposure Therapy might be an effective treatment for PTSD in autistic adults?

Studies have shown that Written Exposure Therapy (WET) can greatly reduce PTSD symptoms. Research suggests that exposure therapy, including WET, helps people confront and work through traumatic experiences, easing PTSD symptoms. Although limited information exists specifically on autistic adults, exposure therapy has succeeded in various groups. Previous findings indicate that WET effectively improves mental health by helping individuals process trauma. This trial will specifically evaluate WET's effectiveness in autistic adults, aiming to determine if these benefits can also help this group, offering a hopeful way to reduce PTSD symptoms. ^{1 2 3 4 5}

Are You a Good Fit for This Trial?

This trial is for autistic adults over 18 who have experienced trauma and show significant traumatic stress symptoms. They must be comfortable with English, have basic internet access for telehealth visits, and score at least 65 on an intelligence test (WASI-2). Those not meeting these criteria or posing a safety risk are excluded.

Inclusion Criteria

Comfortable speaking and writing in English

Full Scale Intelligence Quotient (FSIQ) score >= 65 on the Wechsler Abbreviated Scale of Intelligence-Second Edition (WASI-2)

Access to device with internet access for telehealth visits

Exclusion Criteria

Participant does not have access to internet connected device for telehealth visits

Participant receives Full Scale Intelligence Quotient (FSIQ) score < 65 on the Wechsler Abbreviated Scale of Intelligence-Second Edition (WASI-2)

I cannot understand English.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Initial Assessment

Participants complete an initial assessment involving measures of cognition, autistic traits, PTSD, mental health, and physical health.

1 week

1 virtual visit

Treatment

Participants receive Written Exposure Therapy (WET) over 5 weekly virtual visits, including weekly assessments of PTSD, mental, and physical health.

5 weeks

5 virtual visits

Post-Treatment Assessment

Participants complete a sixth virtual visit for assessment of PTSD, mental and physical health, and treatment feedback.

1 week

1 virtual visit

Follow-up

Participants are monitored for safety and effectiveness after treatment, with re-assessment of PTSD and mental and physical health at 1 and 6 months.

6 months

2 virtual visits

What Are the Treatments Tested in This Trial?

Interventions

• Written Exposure Therapy (WET)

Trial Overview

The study tests the effectiveness of Written Exposure Therapy (WET) delivered via telehealth to reduce PTSD symptoms in autistic adults. It's a pre-post single group design where participants wear Fitbits and attend virtual sessions to assess changes in mental health, physical health, and biobehavioral indicators.

How Is the Trial Designed?

Group I: Written Exposure Therapy Experimental Treatment 1 Intervention

Behavioral therapy: Written Exposure Therapy via telehealth

Who Is Running the Clinical Trial?

University of Wyoming

Lead Sponsor

Trials

20

Recruited

1,600+

Published Research Related to This Trial

Modified written exposure therapy (m-WET) was found to significantly reduce PTSD symptoms in Afghan adolescent girls after a terrorist attack, showing promise as an effective treatment in humanitarian settings.

The study involved 120 participants and demonstrated high acceptability for m-WET, with a low dropout rate of 15%, and no significant difference in outcomes compared to trauma-focused cognitive behavior therapy (TF-CBT).

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Investigating the Feasibility, Acceptability and Efficacy of Using Modified-Written Exposure Therapy in the Aftermath of a Terrorist Attack on Symptoms of Posttraumatic Stress Disorder Among Afghan Adolescent Girls. Ahmadi, SJ., Musavi, Z., Samim, N., et al.[2022]

Children with autism spectrum disorder (ASD) who also have post-traumatic stress disorder (PTSD) are at a higher risk for suicidal thoughts and behaviors, highlighting the need for effective trauma treatments.

The paper presents adaptations for Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) specifically for children with ASD, including strategies for teletherapy that address both trauma and ASD behaviors, ensuring safety and flexibility in treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

TF-CBT Informed Teletherapy for Children with Autism and their Families. Romney, JS., Garcia, M.[2022]

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]

EMDR therapy, when added to standard treatment, significantly reduced symptoms of PTSD, psychological distress, and autistic features in adults with Autism Spectrum Disorder (ASD) who experienced adverse events, with effect sizes indicating strong improvements.

The positive effects of EMDR therapy were maintained even after a follow-up period of 6-8 weeks, suggesting its feasibility and potential effectiveness as a treatment for this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Eye Movement Desensitization and Reprocessing (EMDR) Therapy as a Feasible and Potential Effective Treatment for Adults with Autism Spectrum Disorder (ASD) and a History of Adverse Events. Lobregt-van Buuren, E., Sizoo, B., Mevissen, L., et al.[2021]

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 (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]

In a study of 148 autistic youth aged 7-13 with anxiety disorders, the exposure phase of cognitive-behavioral therapy (CBT) led to significantly faster symptom reduction compared to the cognitive and psychoeducation phases, highlighting the effectiveness of exposure techniques in treating anxiety.

The findings suggest that cognitive strategies alone may slow down symptom improvement, indicating that therapists should prioritize moving quickly to exposure practices to enhance treatment efficacy for autistic youth.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Change during cognitive and exposure phases of cognitive-behavioral therapy for autistic youth with anxiety disorders. Guzick, AG., Schneider, SC., Kendall, PC., et al.[2023]

In a study of 59 adults with autistic spectrum disorder (ASD), over 40% reported probable PTSD symptoms after experiencing both DSM-5 and non-DSM-5 traumatic events, indicating a heightened risk for PTSD in this population.

The findings suggest that a broader range of life events are perceived as traumatic by individuals with ASD, highlighting the need for mental health assessments to include non-DSM-5 traumas to ensure appropriate diagnosis and treatment for PTSD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Experience of Trauma and PTSD Symptoms in Autistic Adults: Risk of PTSD Development Following DSM-5 and Non-DSM-5 Traumatic Life Events. Rumball, F., Happé, F., Grey, N.[2021]

Citations

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The goal is to better understand the initial efficacy and feasibility of WET for supporting autistic adults who have experienced trauma. Official Title.

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withpower.com

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Virtual Trauma Support for Autistic Adults with PTSD

Trial Overview The study tests the effectiveness of Written Exposure Therapy (WET) delivered via telehealth to reduce PTSD symptoms in autistic adults. It's a ...

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pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC6901292/

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Effectiveness of exposure therapy: A case study of posttraumatic stress disorder and mental retardation. Cognitive and Behavioral Practice. 2002;9(4):317 ...

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How do autistic adults experience WET, and how can this program be modified and enhance in the future in collaboration with autistic adults?

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link.springer.com/article/10.1007/s40489-024-00430-9

The Assessment and Treatment of Post-traumatic Stress ...

Autistic adults and children experience more severe PTSD symptoms compared to their non-autistic peers, with at least comparable rates of occurrence.