Adaptation and Randomized Controlled Trial of Written Exposure Therapy for Adolescents

Study Summary

Written Exposure Therapy (WET) is a five-session mental health therapy for posttraumatic stress disorder (PTSD). Research shows that it works as well as longer treatments for PTSD among people over 18, even though it requires fewer sessions than other PTSD therapies. However, WET has not been adapted and formally tested in individual therapy with people aged 12 to 18. The present study aims to see how WET can be adapted to meet the needs of people aged 12 to 18 who have experienced trauma and currently have PTSD symptoms. To adapt WET for this age group, interviews will be conducted with PTSD experts and people aged 12 to 18 to learn what changes would help to make WET more suitable for young people. Next, WET will be delivered to five people aged 12 to 18 (using the WET manual as it is written for people over the age of 18) to obtain feedback about what changes should be made to better meet the needs of this age group. In the next part of the study, 48 adolescents aged 12 to 18 who have symptoms of PTSD will be recruited from an integrated pediatric primary clinic (PPC). Youth and caregivers who agree to participate will be randomized (like the flip of a coin) to either receive the adapted version of WET or to receive our current, gold-standard PTSD treatment: Trauma-Focused Cognitive Behavior Therapy (TF-CBT). Participants assigned to receive adapted WET will take part in five to seven weekly therapy sessions. Participants assigned to receive TF-CBT will take part in 12 to 16 weekly therapy sessions. Participants assigned to both groups will complete five study visits: one before therapy and four follow up assessments at 6-weeks, 10-weeks, 20-weeks, and 30-weeks after starting therapy. The purpose of the study visits occurring over a 30-week time period is to better understand how mental health symptoms and diagnoses may change over time following therapy engagement. All therapy and study visits can be completed remotely or in person, per the participant's prefer

Primary Outcome

The University of California- Los Angeles Posttraumatic Stress Disorder Reaction Index (adolescent and caregiver versions), which are psychometrically strong tools to assess PTSD diagnosis among adolescents, will be administered. Total scores on this measure range from 0 to 108; scores of 35 or higher indicate high likelihood that individuals meet posttraumatic stress disorder (PTSD) diagnostic criteria. Higher scores indicate greater likelihood of meeting diagnostic criteria for PTSD.

Interventions

• BEHAVIORAL Written Exposure Therapy
• BEHAVIORAL Trauma-focused Cognitive Behavior Therapy