Comparing written exposure therapy delivered via telehealth to trauma‐focused expressive writing in undergraduates: A proof‐of‐concept trial

The literature demonstrates that posttraumatic stress disorder (PTSD) rates are estimated to be higher on college campuses compared to lifetime estimates in the general population. Written exposure therapy (WET) is a promising brief intervention for posttraumatic stress symptoms (PTSS) with a growing literature of evidence suggesting efficacy, lower drop-out rates compared to other evidence-based protocols, and long-term treatment gains. This proof-of-concept study examined the efficacy of WET delivered via telehealth compared to expressive writing (EW), the protocol from which WET was derived. The sample included non-treatment-seeking trauma-exposed undergraduate students (N = 33) with elevated PTSS. The results suggest that both WET, g = 1.26, and EW, g = 0.61, were associated with within-person decreases in PTSS. However, reliable change indices indicated that a significantly larger proportion of individuals in the WET condition (61.5%) demonstrated reliable symptom improvement compared to those who received EW (20.0%), g = 0.91. Contrary to our hypotheses, the WET and EW groups did not differ on reliable slopes of change; however, between-group effects were underpowered and should be interpreted with caution. These findings offer preliminary support for WET delivered via telehealth, including for individuals with subthreshold PTSS.