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Completed

NCT Number: NCT06296940

Written Exposure in Substance Treatment

The purpose of this pilot randomized clinical trial is to test the feasibility and efficacy of written exposure therapy (WET) for posttraumatic stress disorder (PTSD) 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 questions the study aims to answer are: 1) Is the delivery of WET feasible in short term residential SUD treatment for individuals with severe SUD; 2) Do participants in the TAU+WET condition have greater reductions in PTSD symptoms pre/post treatment compared to participants in TAU alone?

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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

  • At least 18 years old
  • Fluent in English
  • Cognitively able to provide consent to the research
  • Enrolled in inpatient treatment at the clinical site where the research takes place
  • Meet criteria for probable PTSD based on PCL-5 score
  • Be early enough in their residential stay to allow time to complete the WET protocol
  • Have a clear memory of the traumatic event so they are able to write about itin detail

Exclusion criteria

  • Reports significant suicidal or homicidal ideation with intent, untreated psychosis, or have other health limitations that may interfere with their ability to participate in the research

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.

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 their 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. Efficacy of WET

    Time frame: Pre/post intervention window (approximately 3 weeks)

    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 randomization)

    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

Project WEST (Written Exposure in Substance Treatment) Part 2

Acronym: WEST

Important dates

Study start
2022
Primary completion
2024
Study completion
2024
First posted
Mar 6, 2024
Registry last updated
Jun 10, 2025

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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