Department of Psychiatry and Behavioral Sciences, Duke University Medical Center.
National Center for PTSD, Dissemination and Training Division, VA Palo Alto Health Care System.
Psychol Trauma. 2023 Jul;15(5):748-756. doi: 10.1037/tra0001148. Epub 2021 Oct 28.
Written Exposure Therapy (WET) for posttraumatic stress disorder (PTSD) has been shown to be efficacious in clinical trials; however, research is needed to determine WET's effectiveness in clinical practice settings. Additionally, research is needed to understand whether patient characteristics or treatment delivery format moderate outcomes.
Patient outcomes ( = 277) were assessed as part of a multisite training and implementation program in the Department of Veterans Affairs (VA). During treatment, patients completed self-report measures of PTSD, depression, and functional impairment. Patient characteristics (i.e., demographics, psychiatric comorbidity, trauma type) and treatment delivery format (i.e., telehealth vs. in-person) were assessed as treatment moderators.
Intent-to-treat analyses indicated that WET was effective in reducing PTSD symptoms ( = .84), depression symptoms ( = .47), and functional impairment ( = .36) during treatment. Approximately one quarter of patients dropped out of treatment prematurely. No moderators of PTSD treatment outcome were observed; however, telehealth delivery was associated with lower dropout.
WET was an effective approach across a range of patient characteristics in this sample of veterans with PTSD. WET was also effective whether delivered in-person or via telehealth. WET is a promising treatment option for veteran patients in VA clinical care settings. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
创伤后应激障碍（PTSD）的书面暴露疗法（WET）已在临床试验中被证明是有效的；然而，需要研究来确定 WET 在临床实践环境中的效果。此外，需要研究了解患者特征或治疗提供方式是否调节结果。
作为退伍军人事务部（VA）多地点培训和实施计划的一部分，评估了患者的结果（n=277）。在治疗过程中，患者完成了 PTSD、抑郁和功能障碍的自我报告评估。评估了患者特征（即人口统计学、精神共病、创伤类型）和治疗提供方式（即远程医疗与面对面）作为治疗调节剂。
意向治疗分析表明，WET 在治疗过程中有效降低了 PTSD 症状（ =.84）、抑郁症状（ =.47）和功能障碍（ =.36）。大约四分之一的患者提前退出了治疗。未观察到 PTSD 治疗结果的调节剂；然而，远程医疗的提供与较低的脱落率有关。
在 PTSD 退伍军人的这个样本中，WET 是一种针对各种患者特征的有效方法。无论是面对面还是通过远程医疗提供，WET 都同样有效。WET 是 VA 临床护理环境中退伍军人患者的一种有前途的治疗选择。（PsycInfo 数据库记录（c）2023 APA，保留所有权利）。
