- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05327504
Written Exposure Therapy for Veterans With SUD and PTSD (WET)
April 12, 2024 updated by: VA Office of Research and Development
Written Exposure Therapy (WET) as a Brief Trauma Treatment for Veterans With Co-occurring Substance Use Disorders and PTSD
The proposed project will evaluate the efficacy of written exposure therapy (WET) among Veterans engaged in substance use disorder (SUD) treatment, who present with co-occurring posttraumatic stress disorder (PTSD).
While SUD treatment programs traditionally do not address PTSD, effective trauma treatments have been used successfully among those with substance use comorbidities.
WET is a brief trauma-focused intervention shown to effectively treat PTSD.
In a recent acceptability and feasibility pilot study among Veterans with co-occurring SUD and PTSD, results showed a decrease in PTSD symptoms among participants receiving WET.
The goal of the present study is to improve outcomes for Veterans who present for SUD treatment with comorbid SUD/PTSD.
Study Overview
Status
Recruiting
Intervention / Treatment
Detailed Description
This study is a randomized clinical trial within a Substance Use Disorder (SUD) specialty clinic to evaluate whether treatment as usual (TAU) plus Written Exposure Therapy (WET) is superior to TAU augmented by a neutral topic writing condition on both PTSD and addiction outcomes for Veterans in SUD treatment.
Veterans with a current diagnosis of SUD and comorbid PTSD will be randomized to either WET plus TAU or TAU augmented by a neutral topic writing condition.
During the first writing session, participants will be asked to write about either a personal traumatic experience (WET) or a neutral topic (control).
In sessions 2 through 5, participants will again meet with the study therapist for 45 minutes (maintaining the same writing condition as assigned in session one).
Measures of trauma symptoms, distress, and mood will be collected at each writing session, with additional assessments at baseline, at post-treatment (following 5 writing sessions), 8-weeks, and 12-weeks post-baseline assessment.
The primary aim of this study is to examine whether WET augmentation of TAU improves trauma symptoms for Veterans with SUD and PTSD who are receiving outpatient SUD treatment compared to TAU with a neutral writing control.
The secondary aim will examine whether WET improves SUD outcomes for Veterans with comorbid PTSD compared to TAU with a neutral writing control.
If results prove promising, they will support WET as an effective brief, cost efficient, easy to disseminate, adjunct to current SUD treatment for Veterans with comorbid PTSD.
Study Type
Interventional
Enrollment (Estimated)
170
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
- Name: Michael Merritt
- Phone Number: 6476 (352) 548-6000
- Email: michael.merritt@va.gov
Study Contact Backup
- Name: Jenelle Newcomb, BA
- Phone Number: 2874 (203) 932-5711
- Email: Jenelle.Newcomb@yale.edu
Study Locations
-
-
Connecticut
-
West Haven, Connecticut, United States, 06516-2770
- Recruiting
- VA Connecticut Healthcare System West Haven Campus, West Haven, CT
-
Contact:
- Diana DeNegre
- Phone Number: 5217 203-932-5711
- Email: diana.denegre@yale.edu
-
Principal Investigator:
- Sarah Meshberg-Cohen, PhD MS BS
-
-
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
Description
Inclusion Criteria:
- Veterans ages 18 years old or older;
- Meets DSM-5 criteria for at least one substance use disorder (SUD);
- Meets DSM-5 criteria for PTSD;
- Approved for SUD treatment at VA Connecticut Healthcare System.
Exclusion Criteria:
- Veterans who meet current criteria for schizophrenia, schizophrenia-type disorders, or unmedicated mania or bipolar disorder as determined by QuickSCID-5;
- current suicidal or homicidal risks necessitating a higher level of care;
- Veterans who have received an Evidence-Based Psychotherapy for PTSD protocol within the past 6 months;
- Problems that would prevent a participant from completing the writing intervention or study assessments (e.g., illiteracy). To assess for literacy, participants will read parts of the consent out loud.
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: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Written Exposure Therapy
Written Exposure Therapy (WET) plus Treatment As Usual (TAU).
WET is a 5 session, evidence-based trauma-focused written narrative exposure treatment.
At each session, patients are instructed to write about the same trauma event and therapists provide feedback about adherence and offer suggestions.
The first session includes psychoeducation about PTSD and a treatment rationale prior to general trauma narrative writing instructions, and specific instructions for completing the first writing session, before completing the first writing (30 minutes) session.
Participants are instructed to write about the same trauma event at each following session, with an emphasis on delving into their deepest emotions and thoughts, in as much detail as possible, about the event.
All writing sessions begin with specific instructions from the therapist followed by 30 minutes of writing by the participant.
|
Written Exposure Therapy is a 5 session treatment in which individuals write about their trauma event in a specified manner.
Other Names:
|
Active Comparator: Neutral Topic Writing
Treatment As Usual (TAU) augmented by a neutral topic writing condition.
The neutral topic writing condition involves writing about an assigned topic during each of the five writing sessions.
As opposed to writing about trauma, the specific focus of this condition is on writing for 30 minutes about topics related to their life without writing about emotions or opinions.
Rather, they are asked to write about specific objects or events in detail, as accurately as possible, and with as much description as possible.
All writing sessions begin with specific instructions from the therapist followed by 30 minutes of writing by the participant.
|
Treatment as Usual augmented by 5 sessions of Neutral Topic Writing which involves writing about specific objects (e.g., what they have eaten over the past week) or events (e.g., what they did since yesterday) in detail without discussing thoughts or feelings.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
PTSD Checklist for DSM-5 (PCL-5)
Time Frame: 8-week Post-Baseline Follow-up
|
PTSD Checklist for DSM-5 (PCL-5) will be used to collect information on PTSD symptoms.
The PCL-5 for DSM-5 is a 20-item self-report measure, selected for its dimensional sensitivity, with higher scores reflecting greater PTSD severity.
Scoring is based on how much the patient has been bothered by the symptoms on a scale from "0 = not at all" to "4 = extremely."
PCL scores will be collected based upon symptoms experienced in the past month at Baseline as well as each Post-Baseline Follow-up (8-weeks and 12-weeks), while the weekly PCL-5 will be administered at each of the five writing sessions and post-treatment (after 5 writing sessions) assessment.
PCL-5 total symptom severity scores range from 0 to 80 with higher scores indicating greater PTSD severity.
|
8-week Post-Baseline Follow-up
|
PTSD Checklist for DSM-5 (PCL-5)
Time Frame: 12-week Post-Baseline Follow-up
|
PTSD Checklist for DSM-5 (PCL-5) will be used to collect information on PTSD symptoms.
The PCL-5 for DSM-5 is a 20-item self-report measure, selected for its dimensional sensitivity, with higher scores reflecting greater PTSD severity.
Scoring is based on how much the patient has been bothered by the symptoms on a scale from "0 = not at all" to "4 = extremely."
PCL scores will be collected based upon symptoms experienced in the past month at Baseline as well as each Post-Baseline Follow-up (8-weeks and 12-weeks), while the weekly PCL-5 will be administered at each of the five writing sessions and post-treatment (after 5 writing sessions) assessment.
PCL-5 total symptom severity scores range from 0 to 80 with higher scores indicating greater PTSD severity.
|
12-week Post-Baseline Follow-up
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Timeline Follow-Back (TLFB)
Time Frame: 8-week Post-Baseline Follow-up
|
Timeline Follow-Back (TLFB) will be provided at baseline, and at post-treatment (after 5 writing sessions), 8-week, and 12-week post-baseline follow-up.
Calendar-based interviews using the Timeline Follow-Back (TLFB) method will document the frequency of drug and alcohol use for the 3 months prior to baseline assessment, and during the writing sessions (taken at post-treatment follow-up), 8-week, and 12-week post-baseline follow-up.
Following baseline, the TLFB will capture days since last assessment (e.g., days between baseline and post-treatment, post-treatment, and 8-weeks, and 8- to 12-week follow-up).
Higher numbers of days of use will equal higher substance use.
|
8-week Post-Baseline Follow-up
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Investigators
- Principal Investigator: Sarah Meshberg-Cohen, PhD MS BS, VA Connecticut Healthcare System West Haven Campus, West Haven, CT
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)
September 26, 2022
Primary Completion (Estimated)
May 12, 2027
Study Completion (Estimated)
June 30, 2027
Study Registration Dates
First Submitted
April 6, 2022
First Submitted That Met QC Criteria
April 6, 2022
First Posted (Actual)
April 14, 2022
Study Record Updates
Last Update Posted (Actual)
April 16, 2024
Last Update Submitted That Met QC Criteria
April 12, 2024
Last Verified
April 1, 2024
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- MHBP-010-21F
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
YES
IPD Plan Description
De-identified, anonymized dataset will be created.
This dataset may be shared with other investigators, upon written request, under a data use agreement prohibiting the recipient from identifying or re-de-identifying (or taking steps to identify or re-identify) any individual whose data are included in the dataset.
The data sharing agreement will also restrict redistribution to third parties and proper acknowledgment of the data source.
These datasets will be shared per guidelines provided by VACHS Information Security Officer.
IPD Sharing Time Frame
After study completion
IPD Sharing Access Criteria
After study completion for no less than 7 years
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
product manufactured in and exported from the U.S.
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.
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