Written exposure therapy as treatment for comorbid PTSD and SUD: a systematic review and meta-analysis

Purpose of review This study aimed to evaluate the effectiveness, feasibility, and acceptability of Written Exposure Therapy (WET) when it is used as a component in integrated treatment of comorbid PTSD and Substance Use Disorder (SUD). A systematic review and meta-analysis was used to synthesise foundational knowledge regarding WET. Recent findings Twelve studies were included and analysed in the review. Random-effects meta-analysis of six studies showed large overall pre/post decrease in PTSD severity (Hedges’ g = 1.18, 95% CI [0.68, 1.72], p < 0.001). Rate of retention (69.03%) was higher than typically seen in integrated prolonged exposure treatments for PTSD-SUD. The majority of participants and providers found WET feasible and acceptable. A minority of participants found concurrent treatment for both disorders burdensome. Summary Findings suggest that can be an effective component in integrated treatment of PTSD-SUD, owing to its efficacy, brevity, and low-burden of integration. Limitations of the current findings include small samples, lack of comparator groups, and limited information regarding treatment components and change in SUD.