Delivery of Written Exposure Therapy for PTSD in a University Counseling Center

• Published in: Psychological services 2023-02, Vol.20 (1), p.122-136
• Main Authors: Morissette, Sandra B., Ryan-Gonzalez, Clark, Blessing, Alexis, Judkins, Jason, Crabtree, Meghan, Hernandez, Melissa F., Wiltsey-Stirman, Shannon, Sloan, Denise M.
• Format: Article
• Language: English
• Subjects: Academic achievement; Academic guidance counseling; At risk populations; Brief interventions; Brief Psychotherapy; College Students; Counseling; Counseling services; Educational Measures; Exposure Therapy; Feasibility; Female; Human; Humans; Implosive Therapy; Major Depression; Male; Marxism; Mental depression; Pilot Projects; Post traumatic stress disorder; Posttraumatic Stress Disorder; School Counseling; Self report; Self-efficacy; Stress Disorders, Post-Traumatic - psychology; Student health services; Treatment Outcome; Universities
• ISSN: 1541-1559; 1939-148X
• DOI: 10.1037/ser0000608

Posttraumatic stress disorder (PTSD) occurs at high rates among college students, and there is an urgent need to develop brief and accessible interventions to help these at-risk students achieve academic and career success. This open-trial pilot study tested the feasibility and effectiveness of Written Exposure Therapy (WET; Sloan & Marx, 2019), a brief, five-session exposure-based treatment, when delivered in a real-world Counseling Services Center. Students who met criteria for probable PTSD were assessed at baseline, posttreatment, and 3-month follow-up using self-report assessments of PTSD and depression. Of 28 eligible college students, 22/28 (78.6%) completed at least one treatment session, and of those students, 14/22 (63.6%) completed the full five sessions, 12 of whom completed both the posttreatment assessment and the 3-month follow-up assessment. Data were analyzed using intent-to-treat (N = 22) and per-protocol (n = 12) samples. As hypothesized, in both samples, PTSD symptoms decreased from baseline to posttreatment (η2 = .60-.81; very large effects), and these improvements were maintained at the 3-month follow-up. Similar findings were observed with respect to decreases in self-reported depression, but not with respect to decreases in educational impairment or increases in academic self-efficacy. Qualitative data indicated that both students and therapists found the treatment credible and acceptable. These findings offer preliminary support for the utility of WET for PTSD when delivered in a student counseling services center. Suggestions for adapting WET within a student counseling services environment are discussed. Impact Statement This study suggests that Written Exposure Therapy (WET) for college students with posttraumatic stress disorder (PTSD) resulted in significant reductions in both PTSD and depressive symptoms. WET was credible and acceptable to students and therapists and fit well within the student counseling center environment and semester-driven schedules.