Written exposure therapy delivered to trauma-exposed veterans in primary care: A feasibility study

Despite the number of empirically supported treatments for posttraumatic stress disorder (PTSD) available in U.S. Department of Veterans Affairs (VA) specialty mental health settings, many veterans decline referrals to this setting or do not follow through with recommended care. Thus, the expansion of PTSD services into primary care settings is crucial for increasing access to evidence-based treatments among veterans. To this end, the current pilot project examined the acceptability, feasibility, and preliminary effectiveness of written exposure therapy (WET) delivered to veterans with clinically significant trauma-related symptoms presenting to VA primary care. Veterans (N = 36) were assessed pretreatment, posttreatment, and 1-month follow-up. Mean satisfaction ratings assessed via the Client Satisfaction Questionnaire-8 suggest that the treatment was acceptable (M = 28.00, SD = 3.91). Recruitment and retention rates suggest that the treatment was feasible to deliver, with 88.0% of respondents who expressed interest initiating treatment and 66.0% of those who initiated treatment completing treatment. Further, the results revealed large reductions in PTSD symptom severity from pre- to posttreatment, d = 0.94, and pretreatment to 1-month follow-up, d = 0.89, as assessed using the PTSD Checklist for DSM-5. These findings provide initial support for WET when delivered to veterans presenting with trauma-related symptoms in a primary care setting.