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Written Exposure Therapy Efficacious for PTSD

JAMA Psychiatry; ePub 2018 Jan 17; Sloan, et al

Although written exposure therapy (WET) involves fewer sessions, it was non-inferior to cognitive processing therapy (CPT) in reducing symptoms of posttraumatic stress disorder (PTSD), a recent study found. The findings suggest that WET is an efficacious and efficient PTSD treatment that may reduce attrition and transcend previously observed barriers to PTSD treatment for both patients and providers. In a randomized clinical trial conducted at a Veterans Affairs medical facility, 126 veteran and non-veteran adults were randomized to either WET or CPT. Inclusion criteria were a primary diagnosis of PTSD and stable medication therapy. Exclusion criteria included current psychotherapy for PTSD, high risk of suicide, diagnosis of psychosis, and unstable bipolar illness. Researchers found:

  • For total participants (66 men and 60 women; mean [SD] age, 43.9 [14.6] years), improvements in PTSD symptoms in the WET condition were non-inferior to improvements in the CPT condition at each of the assessment periods.
  • The largest difference between treatments was observed at the 24-week assessment (mean difference, 4.31 points).
  • There were significantly fewer dropouts in the WET vs CPT condition (4 [6.4%] vs 25 [39.7%]).


Sloan DM, Marx BP, Lee DJ, Resick PA. A brief exposure-based treatment vs cognitive processing therapy for posttraumatic stress disorder. A randomized noninferiority clinical trial. [Published online ahead of print January 17, 2018]. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2017.4249.

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