Written Exposure Therapy for PTSD

Written Exposure Therapy (WET) is an effective, evidence-based treatment for PTSD consisting of five to six weekly sessions either in person or telehealth. Using a very structured approach, you receive instructions from the therapist and then complete 30 minutes of writing about the trauma at each session. After writing there is a brief discussion of your experience of the writing process. The therapist reviews your writing between sessions to offer guidance before writing starts at the following session. This treatment has been found to be effective with low drop out rates.

This therapy is appropriate for anyone with PTSD who can meet at least weekly, and is willing to engage with the memory of the traumatic event. 

Explanation and videos from the Veteran’s Administration 

Sloan DM, Marx BP. State of the Science: Written Exposure Therapy for the Treatment of Posttraumatic Stress Disorder. Behav Ther. 2024 Nov;55(6):1222-1232. doi: 10.1016/j.beth.2024.02.004. Epub 2024 Feb 29. PMID: 39443063; PMCID: PMC11700379.

Therapy documentation is highly confidential and receives extra protection under the law. In addition, in this therapy the participant’s writing is destroyed after review by the therapist, and the content of the traumatic event is not entered into the medical record. Documentation of WET in the patient's chart during this process pertain only to the process itself (for example, notes that comment on whether there is improvement in symptoms). 

Many people enter the period of their lives when they are seeking a pregnancy or are pregnant or postpartum with a history of trauma and find that symptoms of PTSD begin to impact their lives in new ways. Some people experience trauma during efforts to conceive, during pregnancy, during labor or postpartum and develop symptoms of PTSD. 

Health care workers have a high risk of PTSD from exposure to actual or threatened death, serious injury, or sexual violence. Birth workers including labor and delivery (L&D) nurses, obstetricians, midwives, and community-based doulas experience PTSD at rates substantially exceeding those of the general population.  

PTSD creates high levels of distress and can impact work, home, relationships and outlook on life.  In the work domain, for example, you may see burnout, stress-related sickness, less sensitive connection to patients, and potential attrition from the profession.  

People are different in their reactions to trauma -- here are some of the symptoms of PTSD

The traumatic event is persistently re-experienced: 

• Unwanted upsetting memories 
• Nightmares 
• Flashbacks 
• Emotional distress after exposure to traumatic reminders 
• Physical reactivity after exposure to traumatic reminders 

Avoidance of things you associate with the trauma: 

• Trauma-related thoughts or feelings 
• Trauma-related reminders 

Negative thoughts or feelings that began or worsened after the trauma: 

• Inability to recall key features of the trauma 
• Overly negative thoughts and assumptions about oneself or the world 
• Exaggerated blame of self or others for causing the trauma 
• Decreased interest in activities 
• Feeling isolated 
• Difficulty experiencing positive emotions 

Trauma-related ways of interacting with the world that began or worsened after the trauma: 

• Irritability 
• Risky or destructive behavior 
• Increased jumpiness or startled easily 
• Difficulty concentrating 
• Difficulty sleeping