Written Exposure in Substance Treatment (WEST 3.0): Randomized Controlled Trial

Potomac Health Foundations

Status: Not yet enrolling

Conditions: Posttraumatic Stress Disorder (PTSD); Substance Use Disorder (SUD)

Treatments: Behavioral: Written Exposure Therapy; Behavioral: Treatment as Usual

Study type: Interventional

Funder types: Other

Identifiers

NCT07782268

WEST 3.0 RCT

Details and patient eligibility

About

The purpose of the current research study is to evaluate the efficacy of the refined Written Exposure in Substance Treatment (WEST) for PTSD among residential SUD patients through a randomized controlled trial. 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. Participants will be randomly assigned to WEST + treatment as usual (TAU) or TAU only. The primary outcome is change in PTSD symptoms from pre-intervention to post-intervention. The secondary outcome will be change in SUD outcomes (e.g., treatment completion, reduced opioid and other drug use) and change in non-PTSD mental health outcomes (e.g., depression) from pre-intervention to post-intervention.

Enrollment: 400 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• be 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 sufficiently able to speak, read, and write in the English language to complete WEST therapy and study assessments.

Exclusion criteria

• Inability to give informed consent for any reason (e.g., cognitive impairment)
• Presence of acute psychosis that would interfere with study participation
• Suicide attempt within the past 3 months
• History of psychiatric hospitalization within the past month
• Presence of any other psychiatric instability or suicidality that would interfere with study participation
• Planning to leave residential treatment before WEST could realistically be completed as determined by the investigator
• Lack of access to a mobile phone after treatment discharge

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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400 participants in 2 patient groups

TAU + Adapted Written Exposure Therapy (WET)

Experimental group

Description:

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.

Treatment:

Behavioral: Written Exposure Therapy

TAU

Active Comparator group

Description:

Treatment as Usual will include a variety of standard care services offered in short term residential treatment.

Treatment:

Behavioral: Treatment as Usual