Adaptation of Written Exposure Therapy in Substance Treatment

NCT07108608 | Not Yet Recruiting

• 1 other identifier: WEST 3.0
• Study Type: interventional
• Target: 20
• Locations: 1 country
• Sites: 1

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?

Conditions

Posttraumatic Stress Disorder; Substance Use Disorders

Keywords

Written Exposure Therapy

Outcome Measures

Primary Outcomes (1)

• PTSD symptom reduction

  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.

  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.

Secondary Outcomes (2)

• Feasibility of WET delivered in residential SUD treatment context

  Up to 4 weeks, or until the participant discharges from residential treatment (whichever comes first).

• Acceptability of WET delivered in residential SUD treatment context

  Collected post intervention window (approximately 3 weeks from enrollment)

Study Arms (1)

TAU + Adapted Written Exposure Therapy (WET)

EXPERIMENTAL

Participants in this condition receive everything included in TAU plus 5 individual sessions of WET delivered by a therapist. WET has been adapted for delivery in a residential SUD setting according to expert feedback. Sessions average less than 60 minutes and primarily involve writing about the traumatic experience that is guided by the therapist.

Behavioral: Written Exposure Therapy; Behavioral: Treatment as Usual

Interventions

Written Exposure Therapy BEHAVIORAL

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.

TAU + Adapted Written Exposure Therapy (WET)

Treatment as Usual BEHAVIORAL

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)

TAU + Adapted Written Exposure Therapy (WET)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• 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.

You may not qualify if:

• 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

Sponsors & Collaborators

• Potomac Health Foundations: lead
• University of Maryland, Baltimore County: collaborator

Study Sites (1)

Maryland Treatment Centers

Baltimore, Maryland, 21229, United States

Location

Related Publications (1)

• Schacht RL, Wenzel KR, Meyer LE, Mette M, Mallik-Kane K, Rabalais A, Berg SK, Fishman M. A pilot test of Written Exposure Therapy for PTSD in residential substance use treatment. Am J Addict. 2023 Sep;32(5):488-496. doi: 10.1111/ajad.13442. Epub 2023 Jun 17.

  PMID: 37329251 BACKGROUND

MeSH Terms

Conditions

Stress Disorders, Post-Traumatic; Substance-Related Disorders

Interventions

Therapeutics

Condition Hierarchy (Ancestors)

Stress Disorders, Traumatic; Trauma and Stressor Related Disorders; Mental Disorders; Chemically-Induced Disorders

Central Study Contacts

Rebecca Schacht, PhD

CONTACT

410.455.562; rschacht@umbc.edu

Kevin Wenzel, PhD

CONTACT

410.233.1400; kwenzel@marylandtreatment.org

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Affiliated Research Scientist

Model Details: Investigators are conducting an uncontrolled trial of approximately 20 subjects who will be assigned to adapted Written Exposure Therapy.

Study Record Dates

• First Submitted: July 29, 2025
• First Posted: August 7, 2025
• Study Start: August 25, 2025
• Primary Completion: April 30, 2026
• Study Completion (Estimated): September 30, 2026
• Last Updated: August 7, 2025

Record last verified: 2025-08

Data Sharing

• IPD Sharing: Will share
• Time Frame: Interested individuals may inquire after data lock is achieved and the primary outcomes paper has been published from this dataset. Estimated time: 2026

Locations

US (1)