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Written Exposure Therapy on Par With Prolonged Exposure Therapy for PTSD
Written exposure therapy (WET) was non-inferior to more time-intensive prolonged exposure therapy (PE) in veterans with post-traumatic stress disorder (PTSD), according to study findings published in JAMA Psychiatry.
The randomized non-inferiority clinical trial included 178 veterans with PTSD from 3 Veterans Affairs medical centers. Among participants, 88 were assigned between five and seven 45- to 60-minute sessions of WET, and 90 were assigned between eight and fifteen 90-minute sessions of PE.
“The WET sessions included 30 minutes of writing-based imaginal exposure conducted in session,” researchers explained, “whereas PE sessions included 40 minutes of in-session imaginal exposure and between-session in vivo exposures.”
Three-quarters of study participants were men, and the average age was 45 years.
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According to the findings, patient changes in PTSD symptom severity, per the Clinician-Administered PTSD Scale for DSM-5, between baseline and 10-, 20-, and 30-week assessments were non-inferior with WET compared with PE. The 10-week assessment showed the largest difference between treatments, with a mean difference of 2.42 points in favor of WET.
Additionally, WET had significantly less attrition. Dropout rates among patients were 12.5% with WET compared with 35.6% with PE.
“Findings suggest that WET may transcend previously observed barriers to PTSD treatment for both patients and clinicians,” wrote first author Denise M. Sloan, PhD, of the VA Boston Healthcare System and National Center for PTSD, Boston, Massachusetts, and study coauthors.
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