Thematic Analysis of Written Exposures in an Integrated Intervention for PTSD and Alcohol Use Disorder Following...

Sexual assault (SA) is alarmingly prevalent and is associated with increased risk for posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD). Exposure-based treatments are a first-line treatment for PTSD and have potential for implementation early after trauma. However, scarce research has been conducted on the application of exposure following recent SA among people with PTSD symptoms and AUD, which is critical to inform the development of effective and tailored early interventions for this population. The present study addressed this gap by using thematic analysis to examine content included in written exposure narratives among 10 adults with recent SA (i.e., in the past 3 months) who received a five-session telehealth-delivered integrated intervention: Skills Training and Exposure for PTSD and Substance Misuse (STEPS). STEPS integrates Written Exposure Therapy for PTSD with cognitive-behavioral skills for AUD to address both concerns simultaneously. Participants demonstrated current symptoms of PTSD and met criteria for AUD. Nineteen themes were identified and organized under five categories: Sensory and Memory Processing, Description of Emotions, Description of Cognitions, Individual-Social Impact, and Reactions to Writing. Findings from this study demonstrate that recent SA survivors with AUD can engage in early exposure-based interventions, such as STEPS, with high protocol adherence (e.g. including sensory details, labeling emotions, expressing cognitions). Results also suggest that interpersonal and sociocultural factors may be important for survivors to process and make meaning of after recent SA.