Long-term treatment gains of a brief exposure-based treatment for PTSD.

BACKGROUND: Written exposure therapy (WET) is a 5-session PTSD treatment that may address barriers in treatment for posttraumatic stress disorder (PTSD) given its brevity and tolerability. A recent study found outcomes for WET were non-inferior to outcomes from Cognitive Processing Therapy (CPT) through 36 weeks from first treatment session (Sloan, Marx, Lee, & Resick, 2018); the current study examined whether treatment gains were maintained through 60 weeks from first session, and also evaluated both treatments' effect on depressive symptoms.

METHODS: The study enrolled 126 individuals with PTSD randomized to WET or CPT. Assessments were conducted at baseline and 6, 12, 24, 36, and 60 weeks following the first treatment session. PTSD diagnosis and symptom severity were determined via the Clinician Administered PTSD Scale for DSM-5 (CAPS-5), and depression symptoms were assessed using the Beck Depression Inventory-2.

RESULTS: WET remained non-inferior to CPT through the 60 week assessment; the groups had a difference of less than 3 points in their total CAPS-5 scores, and within-condition effects on PTSD were large (WET d = 1.23; CPT d = 1.38). Both treatments significantly reduced depressive symptoms over the 60 week study, with the CPT group experiencing a more rapid decrease. The between-condition effect of treatment on depression was small (d = .19).

CONCLUSIONS: WET is a treatment that is non-inferior to CPT with regard to PTSD symptoms, with treatment effects that are long-lasting. Additionally, both WET and CPT demonstrated substantial effects on depressive symptoms. WET should be considered a good option for PTSD treatment.