Identifying predictors of long-term treatment outcomes using narratives from written exposure therapy and cognitive...

Cognitive processing therapy (CPT), a 12-session, gold-standard treatment for posttraumatic stress disorder (PTSD), and written exposure therapy (WET), a brief, five-session treatment, have similar treatment efficacy. The aim of the present study was to identify predictors of long-term treatment outcomes of WET and CPT using clients' written narratives.

Narratives from both treatments were coded with the Change and Growth Experiences Scale coding system to identify predictors of long-term PTSD symptom outcomes. Participants were 113 adults with PTSD randomly assigned to receive WET (n = 60) or CPT (n = 53).

In WET, higher average levels of accommodated (balanced, healthy) beliefs predicted lower PTSD symptoms at the 60-week endpoint, as well as a decrease in symptoms over the follow-up symptom slope. In CPT, higher average negative emotions and positive view of self predicted better 60-week PTSD symptom outcomes, as did lower hopelessness, which also predicted a decrease in PTSD symptoms over the follow-up period.

Even without direct cognitive change techniques, adaptive processing of traumatic experiences occurred in WET and predicted PTSD long-term symptom improvement. Both emotional engagement and cognitive change might help to sustain treatment gains in CPT. (PsycInfo Database Record (c) 2025 APA, all rights reserved).