Posttraumatic Stress Disorder, Substance Use Disorders
Conditions
Keywords
Written Exposure Therapy
Brief summary
The purpose of this pilot non-randomized, uncontrolled clinical trial is to test the feasibility and efficacy of written exposure therapy (WET) for posttraumatic stress disorder (PTSD) as adapted for use 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 question the study aims to answer is: 1) Is the delivery of adapted WET feasible and acceptable in short term residential SUD treatment for individuals with severe SUD?
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. Further, the investigators have adapted WET for this setting based on stakeholder and expert feedback.
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 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
Potomac Health Foundations
University of Maryland, Baltimore County
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Investigators are conducting an uncontrolled trial of approximately 20 subjects who will be assigned to adapted Written Exposure Therapy.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Enrolled in residential SUD treatment at MTC * Meet criteria for PTSD based on the Clinician-Administered PTSD Scale for DSM-5 * Be 18 years of age or older * Have sufficient memory of the index trauma to write about it * Be English speaking.
Exclusion criteria
* Inability to give informed consent for any reason (e.g., cognitive impairment) * Presence of acute psychosis or suicidality that would interfere with study participation * planning to leave residential treatment before WEST could realistically be completed as determined by the investigator
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| PTSD symptom reduction | Pre-WEST intervention; post-WEST intervention (approximately 14 days after randomization, but will vary based on when participants complete the intervention); 4-weeks post enrollment; 8-weeks post enrollment; 12-weeks post enrollment. | 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 enrollment) | 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