Written Exposure Therapy for PTSD

(WEST Trial)

Overseen By Kevin Wenzel, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Potomac Health Foundations

Disqualifiers: Suicidal ideation, Untreated psychosis, others

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

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 5

Duration: 4 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to evaluate how well Written Exposure Therapy (WET) aids individuals with PTSD who are also undergoing treatment for substance use disorders. Participants will receive either standard care or standard care plus five therapist-guided writing sessions, where they will write about their traumatic experiences. The goal is to determine if the writing sessions can more effectively reduce PTSD symptoms compared to standard care alone. This trial may suit those in residential treatment for substance use who have PTSD and can write about their traumatic event. As an unphased trial, it provides a unique opportunity to explore new therapeutic approaches for PTSD and substance use disorders.

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

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 healthcare provider.

What prior data suggests that Written Exposure Therapy is safe for individuals with PTSD in residential SUD treatment?

Research has shown that Written Exposure Therapy (WET) is safe for people with PTSD. Studies indicate it reduces PTSD symptoms and is generally well-received by patients. It has also proven effective for those with mood disorders or substance use issues alongside PTSD, suggesting WET could benefit people dealing with both PTSD and these conditions.

Moreover, WET requires less time than other PTSD treatments, potentially making it easier for people to complete. Importantly, the reviewed studies reported no major safety issues. While individual experiences may vary, evidence suggests that WET is a safe choice for people with PTSD. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Written Exposure Therapy (WET) is unique because it offers a fast and focused approach to treating PTSD. While most standard treatments, like Cognitive Behavioral Therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR), often require lengthy sessions over several months, WET involves just five short sessions that mainly consist of writing about the traumatic experience with guidance from a therapist. This method is designed to be efficient and accessible, making it a promising option for individuals seeking quicker relief from PTSD symptoms. Researchers are excited about its potential to provide effective therapy in a shorter timeframe, potentially increasing access for those who might not have the time or resources for more extended treatment plans.

What evidence suggests that Written Exposure Therapy is effective for PTSD?

Research has shown that Written Exposure Therapy (WET), which participants in one arm of this trial will receive, effectively reduces PTSD symptoms. Studies have found that WET works as well as other PTSD treatments that require more time. Specifically, WET has greatly reduced PTSD symptoms, delivering strong results. It also helps lessen depression symptoms. Additionally, WET is safe for people with PTSD who also have mood or substance use disorders. Overall, WET is a promising treatment for those dealing with PTSD. ^{2 3 6 7 8}

Are You a Good Fit for This Trial?

This trial is for individuals with both substance use disorders (SUD) and post-traumatic stress disorder (PTSD), who are currently in a short-term residential treatment program. The study is designed to see if adding written exposure therapy (WET) to their usual care helps reduce PTSD symptoms more than usual care alone.

Inclusion Criteria

Meet criteria for probable PTSD based on PCL-5 score

Have a clear memory of the traumatic event so they are able to write about it in detail

I am mentally capable of understanding and agreeing to participate in research.

Exclusion Criteria

Reports significant suicidal or homicidal ideation with intent, untreated psychosis, or have other health limitations that may interfere with their ability to participate in the research

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive Written Exposure Therapy (WET) and Treatment as Usual (TAU) in a short-term residential SUD treatment program

4 weeks

5 sessions of WET

Follow-up

Participants are monitored for PTSD symptom reduction and treatment satisfaction

3 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Written Exposure Therapy

Trial Overview The trial tests the addition of written exposure therapy, a treatment for PTSD, to the standard care given in a residential program for substance abuse. It aims to determine if this combined approach is feasible and effective at reducing PTSD symptoms within the context of severe SUD.

How Is the Trial Designed?

Group I: TAU + Written Exposure Therapy (WET) Experimental Treatment 2 Interventions

Participants in this condition receive everything included in TAU plus 5 individual sessions of WET delivered by a therapist. Sessions average less than 60 minutes and primarily involve writing about the traumatic experience that is guided by the therapist.

Group II: Treatment as Usual (TAU) Active Control 1 Intervention

Participants randomized to the TAU condition, which involves the standard clinical services available in a short term residential SUD treatment context. Examples of these services are: Individual counseling/case management; Group psychoeducation; Group counseling; Assessment and addiction related medical treatment from a physician; Pharmacotherapy for substance use disorders; 12-step groups. However, participants in this group do not receive treatment that is targeted at decreasing PTSD symptoms.

Who Is Running the Clinical Trial?

Potomac Health Foundations

Lead Sponsor

Trials

7

Recruited

490+

University of Maryland, Baltimore County

Collaborator

Trials

13

Recruited

2,400+

Citations

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

Written Exposure Therapy for PTSD - PTSD: National ... Findings to date indicate WET is safe and effective for PTSD patients with comorbid mood disorder symptoms, (4,6, 24-27) substance use disorders, (28,29), ...

2. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/34726451/

Effectiveness of written exposure therapy for posttraumatic ... Results: Intent-to-treat analyses indicated that WET was effective in reducing PTSD symptoms (d = .84), depression symptoms (d = .47), and ...

3. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0005789424000297

State of the Science: Written Exposure Therapy for ... The evidence indicates that WET is an efficacious and effective treatment approach for PTSD and is noninferior to more time-intensive evidence-based treatments ...

4. clinicaltrials.gov clinicaltrials.gov/study/NCT01800773

Written Exposure Therapy for Posttraumatic Stress Disorder Outcome data will be collected at baseline and 6-, 12-, 24-, 36- and 60-weeks post-first treatment session. The primary aim is to examine whether PTSD ...

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

Written Exposure Therapy vs Prolonged ... Studies have also shown that WET is noninferior to CPT, with significantly fewer treatment dropouts. Moreover, PTSD symptom severity, ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8390941/

An Open Pilot Trial of Written Exposure Therapy ... Written exposure therapy (WET) is exposure therapy for post-traumatic stress disorder (PTSD). Compared to evidence-based treatments for PTSD, WET requires ...

7. sciencedirect.com sciencedirect.com/science/article/pii/S245186542100065X

Comparing written exposure therapy to Prolonged ... 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. 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.