Brief Treatment for PTSD: Enhancing Treatment Engagement and Retention
Abstract
Objectives and Rationale: Although we have treatments for post-traumatic stress disorder (PTSD) that are known to be effective, too many military personnel avoid treatment or drop out of therapy prematurely, often citing a lack of time among their top treatment concerns. Many also avoid talking about their trauma experience with others, yet this mental re-exposure to their trauma is a key component of what are called "exposure therapies," which research has shown to be the most effective for PTSD. One approach that shows potential for helping many people overcome those barriers to treatment is narrative therapy, in which patients simply write about their trauma. This type of treatment has the benefit of the leading exposure therapies for PTSD in that patients recall and process their trauma through writing, but it tends to be shorter in duration with no out-of-office homework assignments, perhaps making it easier on patients to complete. Studies have begun to document the benefits of narrative therapy with both civilians and Veterans, indicating that reduction in symptoms is comparable to more standard therapies and that the treatment is well received, with extremely low dropout rates. However, it has not yet been studied with active duty military. This proposed study will be conducted with active duty Service members at Fort Hood and measure the effectiveness of a form of narrative therapy for PTSD in which individuals write about their trauma and its effect on them. It will examine whether this therapy, called Written Exposure Therapy (WET), which is delivered in five, weekly sessions, is as effective at reducing PTSD symptoms as a gold-standard talk therapy for PTSD, Cognitive Processing Therapy (CPT), which is delivered in 12 sessions over 6 weeks. The study also will examine patient dropout rates. Researchers believe that WET, with its valuable exposure-based writing component, will be as effective as CPT in alleviating symptoms and helping patients recover from PTSD. They also believe that the shorter course of treatment and fewer time demands will lead to greater patient retention and overall treatment satisfaction. Applicability and Impact: Many people find that writing helps them come to terms with their emotional/psychological experiences, and many find it easier to write about their thoughts and feelings than to discuss them with others. Because of this appeal of simply writing to some people, WET could be a new way to address the challenge of reaching those who are avoiding their symptoms or who have previously chosen not to seek treatment for PTSD. Furthermore, shorter treatments increase the likelihood that individuals can complete a full course of therapy and can realize its full benefits. Clinical Applications, Benefits, and Risks: Traditional therapies rely on trained therapists to guide them throughout the process. WET capitalizes on that expertise, using the therapist to introduce the therapy and rationale for why and how it works as well as to help the individual realize new insights reflected in their writing. However, with fewer sessions that require less direct intervention by the therapist, WET places fewer time demands on providers than standard exposure-based therapies. Shorter, effective treatment options are needed for busy military clinics caring for a crushing load of Service members suffering with PTSD. As with the traditional behavioral therapies, individuals engaging in WET could experience discomfort or emotional distress and a temporary increase in PTSD symptoms, while describing the effect of trauma even in writing, but these experiences are believed to be an important part of the recovery process. Benefits to Service Members, Their Family Members, and the General Public: If proven effective, WET could provide an evidence-based form of PTSD treatment that may be more appealing and more accessible to many Service members who have avoided or discontinued other trea
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Apr 04, 2016
- Source ID
- W81XWH1510391
Entities
People
- Denise M. Sloan
Organizations
- Boston VA Research Institute
- United States Army