Effectiveness of written exposure therapy in group therapy for veterans with PTSD

Combat exposure may lead to posttraumatic stress disorder (PTSD). Although written exposure therapy (WET) is an effective individual treatment for PTSD in soldiers, there is limited evidence supporting its effectiveness in group therapy. This study aims to expand our knowledge on implementing WET in group therapy, specifically among a cohort of 45 Israeli combatants with PTSD following recent participation in the war after October 7, 2023. The group-therapy treatment spanned a total of 12 sessions, incorporating the original WET protocol of five consecutive weekly sessions. The PTSD Checklist (PCL-5), Difficulties in Emotion Regulation Scale (DERS), Negative Mood Regulation Scale (NMR), and Group Cohesiveness Scale (GCS) were utilized before and after the total 12 sessions. Additionally, the Subjective Distress Units Scale (SUDS) assessed distress over the WET sessions. A repeated measures test evaluated the linear association of SUDS scores every week over the five WET sessions. Results revealed that distress symptoms decreased over the course of WET sessions, by means of SUDS score. The most notable reductions were observed between the fourth and fifth sessions. A significant difference in total PCL-5, NMR, and GCS was found before and after the 12 group sessions. All PCL-5 subscales showed significant decrease, while in DERS only the awareness subscale showed significant decrease. A linear trend was found between the end SUDS scores and the five WET sessions. The findings expand the growing literature on implementing WET in group therapy for combatants with PTSD.