Written Exposure in Substance Treatment (WEST 3.0): Randomized Controlled Trial

Treating OUD/PTSD in Residential Care: Written Exposure in Substance Treatment (WEST)

The purpose of the current research study is to evaluate the efficacy of the refined Written Exposure in Substance Treatment (WEST) for PTSD among residential SUD patients through a randomized controlled trial. All participants meet criteria for PTSD and are in a short term residential SUD treatment program (target residential treatment duration = 28 days) regardless of the research. Participants will be randomly assigned to WEST + treatment as usual (TAU) or TAU only. The primary outcome is change in PTSD symptoms from pre-intervention to post-intervention. The secondary outcome will be change in SUD outcomes (e.g., treatment completion, reduced opioid and other drug use) and change in non-PTSD mental health outcomes (e.g., depression) from pre-intervention to post-intervention.

Inclusion Criteria:

• be enrolled in residential SUD treatment at MTC
• meet criteria for PTSD based on the Clinician-Administered PTSD Scale for DSM-5
• be 18 years of age or older
• have sufficient memory of the index trauma to write about it
• be sufficiently able to speak, read, and write in the English language to complete WEST therapy and study assessments.

Exclusion Criteria:

• Inability to give informed consent for any reason (e.g., cognitive impairment)
• Presence of acute psychosis that would interfere with study participation
• Suicide attempt within the past 3 months
• History of psychiatric hospitalization within the past month
• Presence of any other psychiatric instability or suicidality that would interfere with study participation
• Planning to leave residential treatment before WEST could realistically be completed as determined by the investigator
• Lack of access to a mobile phone after treatment discharge