Written Exposure Therapy for PTSD: A Brief Treatment Approach for Mental Health Professionals

131 Pages·2019·2.647 MB·English

by  Denise M Sloan PhD, Brian P. Marx

WRITTEN
EXPOSURE
THERAPY
for PTSD

WRITTEN
EXPOSURE
THERAPY
for PTSD
A Brief Treatment
Approach for
Mental Health
Professionals
DENISE M. SLOAN and BRIAN P. MARX
Copyright © 2019 by the American Psychological Association. All rights reserved. Except
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The foreword was authored by an employee of the United States government as part of
official duty and is considered to be in the public domain.
The opinions and statements published are the responsibility of the authors, and such
opinions and statements do not necessarily represent the policies of the American
Psychological Association. Any views expressed in the foreword do not necessarily
represent the views of the United States government, and the author’s participation
in the work is not meant to serve as an official endorsement.
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Library of Congress Cataloging-in-Publication Data
Names: Sloan, Denise M., author. | Marx, Brian P., author.
Title: Written exposure therapy for PTSD : a brief treatment approach for
mental health professionals / by Denise M. Sloan and Brian P. Marx.
Description: Washington, DC : American Psychological Association, 2019. |
Includes bibliographical references and index.
Identifiers: LCCN 2018051702 (print) | LCCN 2018053102 (ebook) | ISBN
9781433830136 (eBook) | ISBN 1433830132 (eBook) | ISBN 9781433830129
(pbk.) | ISBN 1433830124 (pbk.)
Subjects: LCSH: Post-traumatic stress disorder—Treatment. | Brief psychotherapy. |
Exposure therapy.
Classification: LCC RC552.P67 (ebook) | LCC RC552.P67 S58 2019 (print) |
DDC 616.89/147—dc23
LC record available at https://lccn.loc.gov/2018051702
http://dx.doi.org/10.1037/0000139-000
Printed in the United States of America
10 9 8 7 6 5 4 3 2 1
For Colin—who teaches us every day about patience,
big dreams, hard questions with even harder answers,
and detours that lead to unexpected discoveries
about ourselves and the world around us.

Contents
Foreword—Charles W. Hoge ix
Acknowledgments xiii
Introduction 3
1. Overview of PTSD and Trauma-Focused
Interventions 7
2. Development and Efficacy Findings
of Written Exposure Therapy 19
3. Assessing PTSD Before Beginning Written
Exposure Therapy 35
4. Delivery of Written Exposure Therapy
and Special Considerations 47
5. Frequently Asked Questions About Delivering
Written Exposure Therapy 67
6. Case Illustrations 73
Appendix: Written Exposure Therapy Script 91
References 99
Index 111
About the Authors 115
vii

Foreword
The availability of evidence-based treatments for posttraumatic stress dis-
order (PTSD) has changed dramatically over the past 2 decades, driven in part
by large allocations of funding to expand the care for service members and
veterans returning from the wars in Iraq and Afghanistan, who now routinely
receive services not available to past generations of warriors. Two trauma-
focused psychotherapies, prolonged exposure (PE) and cognitive process-
ing therapy (CPT), mandated for uniform dissemination across Veterans
Affairs (VA) facilities, have become the dominant treatments in the United
States. Funding for research, including randomized clinical trials, has also
expanded, and since these wars began, the VA and the Department of Defense
(DoD) have produced three revisions of the clinical practice guideline for
PTSD (in 2004, 2009, and 2017).
The most striking change in the latest VA/DoD PTSD clinical practice
guideline, informative to clinical practice internationally, is that medications
(particularly those targeting serotonin reuptake) are no longer considered
equivalent to trauma-focused psychotherapy for the primary treatment of
PTSD. The evidence review suggested that individual trauma-focused psycho-
therapy produced higher and longer lasting effect sizes than medications.
This foreword was authored by an employee of the United States government as
part of official duty and is considered to be in the public domain. Any views expressed
herein do not necessarily represent the views of the United States government, and
the author’s participation in the work is not meant to serve as an official endorsement.
ix