Written Exposure Therapy for Childbirth-related Post-Traumatic Stress (SCRIBE)

November 6, 2026 updated by: Amanda Koire, Brigham and Women's Hospital

Written Exposure Therapy (WET) for the Treatment of Childbirth-related Post-Traumatic Stress: A Pilot Study

In this research study, the investigators hope to determine whether Written Exposure Therapy is a feasible intervention for postpartum women experiencing trauma symptoms related to childbirth to complete. Written Exposure Therapy involves five structured psychotherapy sessions that can be conducted over telehealth.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Childbirth-related posttraumatic stress disorder (CB-PTSD) affects approximately one in twenty women after any given childbirth. Postpartum women are faced with unique barriers to accessing and engaging in evidence-based treatment for PTSD. Aside from avoidance, limited time and financial and logistical barriers regarding childcare can make it difficult to engage in long-term therapy or travel to frequent in-person visits. Therefore, postpartum individuals may find a brief telehealth-based intervention, Written Exposure Therapy, to be highly appealing and well-aligned with the demands of postpartum parenting.

Written exposure therapy (WET) is a highly protocolized evidence-based brief psychotherapeutic intervention for the treatment of PTSD that may be promising for women with CB-PTSD. WET consists of 5 treatment sessions. In the first, patients receive brief psychoeducation about PTSD and avoidance as a maladaptive behavior that maintains PTSD symptoms. In each of the five sessions, the patient writes about the same single traumatic event with a focus on feelings and cognitions during the event and how the event has affected their lives. Written exposure therapy can be conducted via telehealth, does not require between-session assignments for patients, is non-inferior to cognitive processing therapy and prolonged exposure therapy, and involves only four total hours of treatment, thus decreasing treatment time by 50-80% compared to other evidence-based psychotherapies for PTSD. This study aims to assess whether postpartum individuals would find such an intervention feasible and be able to maintain engagement to complete the protocol.

Study Type

Interventional

Enrollment (Estimated)

15

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

    • Massachusetts
      • Boston, Massachusetts, United States, 02115
        • Recruiting
        • Brigham and Women's Hospital
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

Female

Description

Inclusion Criteria:

  • Birthing individuals
  • 18 years of age or older
  • Living in Massachusetts
  • Can read, write, and speak English
  • Identified a traumatic event exposure related to their childbirth experience
  • Are between one month to two years postpartum
  • Have a probable CB-PTSD diagnosis based on a PCL-5 score ≥ 28.

Exclusion Criteria:

  • Current engagement in another form of trauma-focused psychotherapy
  • No or little memory of the traumatic event
  • Safety concerns including active suicidality, active psychosis, and heavy substance use with inability to cease substance use for at least 2 hours before and after each session.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Written Exposure Therapy

Written exposure therapy (WET) is a highly protocolized evidence-based brief psychotherapeutic intervention for the treatment of post-traumatic stress disorder (PTSD).

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Feasibility (retention rate)
Time Frame: From date of the first WET session until the date of the fifth WET session, withdrawal from the study, or determination of loss to follow-up, whichever occurs first (estimated average assessment period: 6 weeks).

Feasibility will be measured retention rate across five Written Exposure Therapy (WET) sessions. Retention rate is defined as the number of participants who complete all five WET sessions divided by the total number of participants who engaged in at least one WET session. A higher value indicates higher retention. We expect at least 75% of enrolled participants will complete treatment once initiated.

From date of the first WET session until the date of the fifth WET session, withdrawal from the study, or determination of loss to follow-up, whichever occurs first (estimated average assessment period: 6 weeks).
Feasibility (Engagement rate)
Time Frame: From the date of enrollment until the date of the first WET session, withdrawal from the study, or determination of loss to follow-up, whichever occurs first (estimated average assessment period: 4 weeks).

Engagement will be measured as the number of participants who engaged in at least one Written Exposure Therapy session divided by the number of women who enrolled in the study. A higher value indicates higher engagement. We expect at least 75% of enrolled participants will engage in treatment.

From the date of enrollment until the date of the first WET session, withdrawal from the study, or determination of loss to follow-up, whichever occurs first (estimated average assessment period: 4 weeks).
Acceptability (Credibility)
Time Frame: Baseline

Credibility will be measured using the pre-intervention credibility/expectancy questionnaire (CEQ) which assesses patient perception of whether treatment seems logical and useful. Credibility is scored as the sum of the first three scale items on the credibility/expectancy questionnaire. Scores range from 3-27, with higher scores indicating greater credibility.

Baseline
Acceptability (Satisfaction)
Time Frame: Study exit survey approximately 4 weeks after final WET session.

Satisfaction will be measured as total score on the post-intervention Client Satisfaction Questionnaire-8 (CSQ-8) survey. Scores range from 8-32, with higher numbers indicating greater satisfaction.

Study exit survey approximately 4 weeks after final WET session.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Changes in PTSD Symptoms Assessed by the PTSD Checklist for DSM-5
Time Frame: From enrollment to study exit survey approximately 4 weeks after the final written exposure therapy session.

The PTSD Checklist for DSM-5 (PCL-5) is a 20-item self-report measure that assesses the 20 DSM-5 symptoms of PTSD. Scores range from 0 to 80 and a score at or above 28 is indicative of probable CB-PTSD. A 9 point change represents reliable change.

From enrollment to study exit survey approximately 4 weeks after the final written exposure therapy session.
Changes in EPDS Symptoms Assessed by the Edinburgh Postnatal Depression Scale
Time Frame: From enrollment to study exit survey approximately 4 weeks after the final written exposure therapy session.

The Edinburgh Postnatal Depression Scale (EPDS) is a 10-item self-report questionnaire used during pregnancy and postpartum to screen for perinatal and postpartum depression. Scores range from 0-30 and a score at or above 10 is indicative of a positive screen for perinatal depression. A 4 point change indicates reliable change.

From enrollment to study exit survey approximately 4 weeks after the final written exposure therapy session.
Changes in PSS Symptoms Assessed by the Perceived Stress Scale
Time Frame: From enrollment to study exit survey approximately 4 weeks after the final written exposure therapy session.

The Perceived Stress Scale (PSS) is a 10-item self-report questionnaire designed to assess perceptions of recent stress. Scores range from 0 to 40, with higher scores indicating higher perceived stress. A 6 point change indicates reliable change.

From enrollment to study exit survey approximately 4 weeks after the final written exposure therapy session.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Collaborators

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

February 11, 2026

Primary Completion (Estimated)

July 31, 2027

Study Completion (Estimated)

August 31, 2027

Study Registration Dates

First Submitted

October 13, 2026

First Submitted That Met QC Criteria

November 6, 2026

First Posted (Actual)

November 13, 2026

Study Record Updates

Last Update Posted (Actual)

November 13, 2026

Last Update Submitted That Met QC Criteria

November 6, 2026

Last Verified

November 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • 2025P000531

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be shared due to privacy and confidentiality concerns. Aggregate study results will be made publicly available on ClinicalTrials.gov and through publications.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.