Posttraumatic Stress Disorder, Substance Use Disorders
Conditions
Keywords
Written Exposure Therapy
Brief summary
The purpose of this pilot randomized clinical trial is to test the feasibility and efficacy of written exposure therapy (WET) for posttraumatic stress disorder (PTSD) within the context of residential substance use disorder (SUD) treatment. All participants meet criteria for PTSD and are in a short term residential SUD treatment program (target residential treatment duration = 28 days) regardless of the research. The main questions the study aims to answer are: 1) Is the delivery of WET feasible in short term residential SUD treatment for individuals with severe SUD; 2) Do participants in the TAU+WET condition have greater reductions in PTSD symptoms pre/post treatment compared to participants in TAU alone?
Interventions
BEHAVIORALWritten Exposure Therapy
Written Exposure Therapy is a brief, evidenced based intervention for PTSD. WET is generally delivered individually across 5 sessions in which the therapist guides the patient through writing exercises. Across exposure sessions, participants experience habituation so that their symptoms decrease by the end of treatment. WET has an established evidence base in general outpatient psychotherapy for PTSD, but has not been adapted or tested in residential SUD treatment settings.
BEHAVIORALTreatment as Usual
Treatment as Usual will include a variety of standard care services offered in short term residential treatment. For example, participants receiving TAU will participate in individual case management/general counseling sessions focused on their substance use disorder and its consequences, group based psychoeducation sessions, group based counseling sessions (e.g., relapse prevention planning), individual services with a medical provider and pharmacotherapy (e.g., for withdrawal, relapse prevention, or co-occurring conditions)
Sponsors
University of Maryland, Baltimore County
Potomac Health Foundations
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
We are conducting a randomized controlled trial of approximately 50 randomized subjects (up to 100 total enrollments) who will be assigned 1:1 to treatment as usual (TAU) or TAU+WET.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* At least 18 years old * Fluent in English * Cognitively able to provide consent to the research * Enrolled in inpatient treatment at the clinical site where the research takes place * Meet criteria for probable PTSD based on PCL-5 score * Be early enough in their residential stay to allow time to complete the WET protocol * Have a clear memory of the traumatic event so they are able to write about itin detail
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Efficacy of WET | Pre/post intervention window (approximately 3 weeks) | PTSD symptom reduction pre/post intervention by treatment arm as measured by the posttraumatic checklist for DSM-5 (PCL-5). The PCL-5 is a self-report questionnaire yielding scores ranging from 0-80 with higher scores indicating greater symptomology. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Feasibility of WET delivered in residential SUD treatment context | Up to 4 weeks, or until the participant discharges from residential treatment (whichever comes first). | Percentage of participants in the WET arm who were able to complete the treatment (5 sessions) prior to discharge |
| Acceptability of WET delivered in residential SUD treatment context | Collected post intervention window (approximately 3 weeks from randomization) | Treatment satisfaction scores among WET participants as measured by the 2-part credibility/expectancies questionnaire (CEQ). The CEQ utilizes two scoring systems that range from 1-9 or 0%-100%. with higher scores indicating greater acceptability. |
Countries
United States
Outcome results
None listed