None listed
Conditions
Brief summary
Five sessions of written exposure therapy (WET), a protocol-driven therapy, are equivalent to the twenty sessions of Prolonged Exposure therapy (PET) (a gold standard treatment) for post-traumatic stress disorder (PTSD).WET requires 30 minutes of writing about a traumatic event over five weekly sessions. WET has a dropout rate of 6% to 13% compared with 25% to 39% for PET. The Calder Clinic is a Primary Care Clinic (Auckland City Mission). Almost all Calder patients have PTSD, often from adverse childhood events. It takes 19 years for patients In New Zealand to get PTSD. About 50% of the Calder patients are Maori, who have the highest rates of PTSD. We propose to conduct a randomised trial of once-weekly versus twice-weekly (faster) WET therapy to see if faster therapy speeds up improvement and demonstrates it is feasible in a primary care setting. The WET developers want it trialled in primary care as it is designed for use by a wide range of health professionals.
Interventions
The intervention of 4 sessions of written exposure therapy over two weeks (the faster option). There will be five 30-minute writing sessions where participants will be asked to write in detail what happened and what their emotions were about the event(s). When there are multiple events, they are asked to describe the one that has impacted them most. If they finish before the 30 minutes is over, they will be asked to start again from the beginning. The intervention will done by a clinician in the
The intervention of 4 sessions of written exposure therapy over two weeks (the faster option). There will be five 30-minute writing sessions where participants will be asked to write in detail what happened and what their emotions were about the event(s). When there are multiple events, they are asked to describe the one that has impacted them most. If they finish before the 30 minutes is over, they will be asked to start again from the beginning. The intervention will done by a clinician in the primary care team and done face to face or by Zoom if remote. If they have difficulty in writing, they can do it verbally into an audio recorder. They will do the writing in a private room. The location will be in a primary care clinician. We will record what we say as clinicians (interventions) for 10% of the consultations and have another investigator do a fidelity check. All participants will get five sessions. They do one before randomisation and if they return for a second one they will then be invited in to be randomisation. This is to prevent excessive dropouts
Sponsors
Whau Foundation
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject)
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
1. Diagnosis of PTSD by a score of equal to or less than 35 on a PCL-5. 2. If taking psychotropic medication on a stable dose for at least 30 days before study entry 3. Aged 18 to 80
Exclusion criteria
1. Current engagement in psychosocial treatment for PTSD. 2. Current diagnosis of severe substance use disorder. Those using heroin, other opiates, synthetic cannabis and methamphetamine will be excluded. (mild to moderate severity will not be excluded, e.g., alcohol and cannabis -participants using alcohol and cannabis will be asked not to use it on the days of doing WET therapy and for the day following WET therapy. This will protect against using substances as an avoidance tool for any post-therapy distress. We will need to make an individual decision about current substance use at the time of enrolment as there may be variations we have not considered. 3. Current psychosis or unstable bipolar disorder diagnosis. 4. High suicidal risk (i.e., intent with a plan). 5. Significant cognitive impairment (assessed with clinical judgement). 6. Inability to understand the ethics information sheet.
Outcome results
None listed