Category: Treatment - CBT

Symposium

Symposium 61 - A Randomized Controlled Trial of Written Exposure Therapy for PTSD: Outcomes, Moderators, and Mediators

Friday, November 17
5:15 PM - 6:15 PM
Location: Sapphire Ballroom B, Level 4, Sapphire Level

Keywords: PTSD (Posttraumatic Stress Disorder) | Randomized Controlled Trial | Psychotherapy Process
Presentation Type: Symposium

Prior research has shown that approximately one third of those who receive Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT) terminate treatment prematurely (Imel et al., 2013). Further, providers trained to use these treatments report infrequent use, citing time limitations and high clinical care demands as barriers (Finley et al., 2015; Wilks et al., 2013). These data underscore the need for identifying alternative, more efficient treatments that address patient and provider concerns. One such alternative is Written Exposure Therapy (WET), a five session treatment for PTSD shown to be efficacious and associated with low treatment dropout (e.g., no more than 10%).  Although the efficacy data for WET indicates effect sizes that are comparable with PE and CPT, WET has not yet been directly compared with either of these treatments. This symposium will present findings from a recently conducted study in which WET is directly compared with CPT to examine if these two treatments are equally efficacious, as well as to compare dropout rates and investigate mediators and moderators of outcome. The study includes 126 adults (66% women) who were randomly assigned to receive either WET or CPT.  Assessments were conducted at multiple time points across the course of one year.  Three presentations will be included in this symposium. Dr. Sloan will first describe the treatment outcome findings of the study and whether the hypothesis that WET is equally efficacious compared with CPT is supported. She will also present data on treatment dropout for the two treatments (e.g., number of dropouts, reasons for dropout, and when dropout is likely to occur). Dr. Marx will present findings on factors that may moderate treatment outcome (e.g., estimated IQ, trauma type, time since trauma event, number of Criterion A trauma events, gender, baseline perceived social support, and baseline depression). Lastly, Dr. Barnes will present on therapeutic processes within and between treatment conditions and associations with treatment outcome. Specifically, multimodal trauma network activation (i.e., a composite code of cognitions, emotions, behaviors, and somatic sensations expressed while recounting index traumas), avoidance, and cognitive variables (assimilation, accommodation, overgeneralization) will be coded using the written narrative components of both treatments. Dr. Barbara Rothbaum will serve as a discussant.


We are not describing the findings for each of the presentations within this proposal because the study is currently in the follow up phase. Consequently, we are not able to conduct statistical analyses at this time. However, randomization of the targeted 126 participants for the study has been completed and the treatment phase was completed in January of 2017.  We will have completed the follow up phase for the analyses to be conducted by the time of the meeting. In fact, we expect to have the papers describing these findings at least under review if not in press by the time of the ABCT meeting.

Learning Objectives:

Denise M. Sloan

Associate Director
National Center for PTSD, VA Boston Healthcare System

Presentation(s):

Send Email for Denise Sloan

Barbara Rothbaum

Professor of Psychiatry
Emory University School of Medicine

Presentation(s):

Send Email for Barbara Rothbaum

Denise M. Sloan

Associate Director
National Center for PTSD, VA Boston Healthcare System

Presentation(s):

Send Email for Denise Sloan

Brian P. Marx

Principle Investigator
National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System

Presentation(s):

Send Email for Brian Marx

Benjamin Barnes

Postdoctoral fellow (effective Aug. 1, 2017)
University of Delaware

Presentation(s):

Send Email for Benjamin Barnes


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Symposium 61 - A Randomized Controlled Trial of Written Exposure Therapy for PTSD: Outcomes, Moderators, and Mediators



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