Brief Treatment for PTSD: Enhancing Treatment Engagement and Retention
Denise Sloan, PhD
Examine whether a form of narrative therapy in which patients write about their trauma is as effective in treating PTSD as a gold-standard form of talk therapy. Examine whether the narrative therapy, with a shorter course of treatment and fewer time demands, leads to increased patient retention and overall treatment satisfaction.
Although we have treatments for posttraumatic stress disorder (PTSD) that are known to be effective, too many military personnel avoid therapy or drop out prematurely, often citing a lack of time. Many also avoid talking about their trauma experience with others, yet this mental re-exposure to their trauma is a key component of effective treatments called “exposure therapies.”
One approach that could help many people overcome barriers to treatment is a form of narrative therapy called Written Exposure Therapy (WET). Patients in WET simply write about their trauma, gaining the benefit of exposure therapies. WET may be easier for patients to complete because it is short in duration, with no out-of-office homework assignments. Although some studies have found narrative therapy comparable to more standard therapies in reducing PTSD symptoms in civilians and veterans, it has not yet been studied with active duty military.
Comparing WET to a leading talk therapy
In this STRONG STAR-affiliated study, a team of investigators led by Denise Sloan, PhD, of the Department of Veterans Affairs’ National Center for PTSD and the Boston University School of Medicine, will measure the effectiveness of WET with active-duty service members in San Antonio and Killeen, Texas. The research team will examine whether WET is as effective at reducing PTSD symptoms as a gold-standard talk therapy for PTSD called Cognitive Processing Therapy, Cognitive-only version (CPT-C).
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-C 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. WET is delivered in five weekly sessions, with the first session lasting an hour and the remaining four lasting 40 minutes. CPT-C requires 12 one-hour sessions delivered twice weekly over six weeks.
If proven effective, WET could provide an evidence-based form of PTSD treatment that is appealing and accessible to many service members who have avoided or discontinued other treatments. It requires a shorter treatment period and can be administered by peer counselors as well as psychotherapists, with less direct provider supervision required compared to more traditional therapies. These features of the treatment would help increase the number of patients who could be served in the busy military mental health care system as it strives to improve the emotional, mental, and physical health of thousands of service members suffering silently with PTSD.
In addition, the general public would benefit through improved force readiness and potentially reduced military costs of PTSD-related lost-work time and veteran disability benefits. Civilians with PTSD also may benefit from yet another effective treatment option.