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Completed

NCT Number: NCT07108608

Adaptation of Written Exposure Therapy in Substance Treatment

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?

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Key information

Conditions

Posttraumatic Stress Disorder Chemically-Induced Disorders Mental Disorders Stress Disorders, Post-Traumatic Stress Disorders, Traumatic Substance Use Disorders Substance-Related Disorders Trauma and Stressor Related Disorders

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Maryland Treatment Centers

Baltimore, Maryland, 21229, United States

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • 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.

Exclusion criteria

  • 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

Treatment and study plan

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.

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)

Primary outcomes

  1. PTSD symptom reduction

    Time frame: 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.

    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.

Secondary outcomes

  1. Feasibility of WET delivered in residential SUD treatment context

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

    Percentage of participants in the WET arm who were able to complete the treatment (5 sessions) prior to discharge

  2. Acceptability of WET delivered in residential SUD treatment context

    Time frame: Collected post intervention window (approximately 3 weeks from enrollment)

    Treatment satisfaction scores among WET participants as measured by the 2-part credibility/expectancies questionnaire (CEQ). The CEQ utilizes two scoring systems that range from 1-9 or 0%-100%. with higher scores indicating greater acceptability.

Sponsors and collaborators

Lead sponsor

Potomac Health Foundations

Other

Collaborators

  • University of Maryland, Baltimore County

Registry information

Official study title

Treating OUD/PTSD in Residential Care: Written Exposure in Substance Treatment (WEST).

Acronym: WEST

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Aug 7, 2025
Registry last updated
Jun 29, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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