Written Exposure Therapy Effective for Service Members with PTSD

New research indicates that a five-session treatment of written exposure therapy, is equally effective for military service members suffering from Posttraumatic Stress Disorder (PTSD), as the more time-intensive cognitive processing therapy.

“PTSD is more common among Veterans and military service members, and in this treatment study, the dropout rates for written exposure therapy were significantly lower than for cognitive processing therapy, while the difference in PTSD outcome was not statistically significant,” said the paper’s lead author, Denise M. Sloan, PhD, a VA Boston psychologist, associate director for the Behavioral Science Division of the National Center for PTSD and BUSM professor of psychiatry. “This suggests that written exposure therapy can be an efficient treatment option for military service members suffering from PTSD.”

In written exposure therapy the patient repeatedly writes about a traumatic event, and the therapist focuses on the patients’ experiences while writing about the trauma, rather than the event itself. The therapy has demonstrated effectiveness, but prior clinical treatment studies focused on civilian samples.

In this trial, the written exposure therapy treatment consisted of five weekly sessions with no in-between session assignments, while cognitive processing therapy consisted of 12 twice-weekly sessions with between session assignments. Overall, 169 active-duty service members participated in the study, more than 80 percent of whom were male and over 98 percent were serving in the Army. Participants were randomly assigned to written exposure therapy or cognitive processing therapy.

The trial supported written exposure therapy as an effective and more efficient treatment option for service members with PTSD, with significantly lower dropout rates; treatment dropout rates were 24 percent for written exposure therapy and 45 percent for cognitive processing therapy. The paper, published in JAMA Network Open, recommended future research to determine which patients benefit from written exposure therapy and which do not, to maximize treatment outcomes.