Perceived Barriers and Preliminary PTSD Outcomes in an Open Pilot Trial of Written Exposure Therapy With Latinx Immigrants

Andrews, Arthur R.; Acosta, Laura M.; Canchila, M. Natalia Acosta; Haws, J. Kyle; Holland, Kathryn J.; Holt, Natalie R.; Ralston, Allura L.

doi:10.1016/j.cbpra.2021.05.004

Cited by 14 publications

(15 citation statements)

References 57 publications

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“…This study examined potential recipients’ and providers’ perceptions of barriers and facilitators of WET, how their perceptions of WET compare to mental health treatment in general, as well as their perceptions on the acceptability and feasibility of WET. Findings from this study extend prior results supporting efficacy (Andrews et al, 2021) and further support the acceptability and feasibility of WET among a Spanish-speaking sample. Prior work by our research team had previously demonstrated preliminary efficacy in reducing PTSD symptoms among Spanish-speaking immigrants with elevated, but not necessarily diagnostic, symptoms of PTSD.…”

Section: Discussionsupporting

confidence: 85%

“…Additionally, Benuto and Bennett (2019) successfully implemented WET in one case study with a Latinx immigrant, offering a highly preliminary indication of potential feasibility and effectiveness. Similarly, preliminary research from our team has demonstrated significant PTSD and depression symptom reduction in a Latinx immigrant sample, while qualitative data also highlighted that participants largely reported perceiving WET as beneficial (Andrews et al, 2021).…”

Section: Ptsd Treatment and Barriers Among Latinx Immigrantsmentioning

confidence: 87%

Section: Purposementioning

confidence: 91%

“…The present study is part of a larger pilot study evaluating WET among Latinx immigrants and sought to assess the acceptability of WET among potential recipients and providers. Our prior work with these data has already demonstrated PTSD and depression symptom reduction and compared pre and posttreatment perceived barriers to WET among treatment recipients only (Andrews et al, 2021). In the present study, we aimed to:Compare mental health provider and potential recipients’ perceptions of barriers for mental health services in generalCompare mental health provider and potential recipients’ perceptions of potential remedies to barriers of mental health services in generalCompare mental health provider and potential recipients’ perceptions of barriers for Spanish-language WETCompare mental health provider and potential recipients’ perceptions of potential remedies to barriers for Spanish-language WETCompare and contrast overall perception of barriers for Spanish-language WET with those of mental health services in generalExamine provider and patient perceptions on the acceptability and likelihood of use of our Spanish-language adaptation of WET…”

Section: Ptsd Treatment and Barriers Among Latinx Immigrantsmentioning

confidence: 94%

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Examining recipient and provider perceptions of mental health treatments and written exposure therapy for posttraumatic stress disorder with a Spanish-speaking sample.

Acosta¹,

Canchila²,

Reyes³

et al. 2023

Psychological Services

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Treatments of Posttraumatic Stress Disorder (PTSD) often evidence high rates of dropout, ranging from 25% to 40%, among English-speaking samples. Written Exposure Therapy (WET), a novel manualized treatment for PTSD, evidences lower dropout rates and noninferiority to CPT, one of the most efficacious interventions for PTSD. Spanish-speaking Latinxs often experience greater dropout and barriers to care. WET appears promising for this population, but acceptability and perceived barriers to WET have not been examined among Spanish-speaking Latinxs. The present study assessed perceptions and acceptability of a Spanish-language version of WET among Spanish-speaking Latinxs who scored greater than 45 on the Spanish-language version of the PCL-IV, indicating likely PTSD (n = 20) and providers (n = 12). Participants completed a mixed-methods interview regarding reasons they/clients would not want to receive the treatment, why they/clients would want to receive the treatment, potential solutions for any identified barriers, and reasons for not seeking mental health services generally. Providers, but not potential recipients, identified low literacy as a barrier for WET. Providers and potential recipients identified time as a barrier to WET and other mental health services, but the time reduction was perceived as a potential facilitator of WET. Results also suggest no specific cultural barriers were identified for WET (e.g., provider cultural competency) and that Spanish WET may reduce time-related barriers and is perceived as effective and acceptable among Spanish-speaking Latinxs. Additional work is needed to expand the reach of the intervention, given that mental health services were often perceived as untrustworthy. Impact StatementThis study suggests that a Spanish-language adaptation of Written Exposure Therapy, a novel manualized treatment for PTSD symptoms, may be effective in reducing some structural barriers that Spanish-speaking Latinx populations encounter when using mental health services.

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Section: Discussionsupporting

confidence: 85%

Section: Ptsd Treatment and Barriers Among Latinx Immigrantsmentioning

confidence: 87%

Section: Purposementioning

confidence: 91%

Section: Ptsd Treatment and Barriers Among Latinx Immigrantsmentioning

confidence: 94%

See 2 more Smart Citations

Examining recipient and provider perceptions of mental health treatments and written exposure therapy for posttraumatic stress disorder with a Spanish-speaking sample.

Acosta¹,

Canchila²,

Reyes³

et al. 2023

Psychological Services

Self Cite

View full text Add to dashboard Cite

show abstract

“…Accounting for COVID-19 related reasons, the dropout rate was ~18% in the current study, which parallels other PTSD intervention study dropout estimates (Imel et al, 2013). When compared with the Written Exposure Therapy protocol, which is similar in number of sessions but different in active ingredients and mechanisms of change compared to PPMT, the dropout rate in the current study was lower (Andrews et al, 2021). Future research needs to examine reasons for dropout from PPMT which will inform feasibility considerations as well as any needed refinements.…”

Section: Discussionmentioning

confidence: 70%

Positive affect processes and posttraumatic stress disorder symptoms: Findings from an open label and uncontrolled pilot study using the positive memory processing technique.

Contractor¹,

Slavish²,

Thornton³

et al. 2023

Journal of Psychotherapy Integration

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Recently, a five-session processing of positive memories technique (PPMT) was proposed as a novel intervention for posttraumatic stress disorder (PTSD). One purported outcome of and mechanism underlying PPMT’s effects on PTSD is improved positive affect processes. In this uncontrolled pilot study, we examined whether PPMT was associated with decreases in PTSD severity; and whether changes in positive affect levels, reactivity, and dysregulation related to changes in PTSD severity across sessions. The sample included 16 trauma-exposed participants seeking services at a University Psychology Clinic (Mage = 27.44 years; 68.80% women). Multilevel linear growth models examined the main effects of each positive affect variable and their interactions with time on PTSD severity. PTSD severity decreased across PPMT treatment in each model (bs = −.43 to −.33; d = −.03; ps < .001–.008). There was a main effect of positive emotion dysregulation (b = 1.16, d = .11; p = .009), but not of positive affect levels (p = .821) or reactivity (p = .356) on PTSD severity. However, positive affect processes did not modify the trajectory of PTSD severity across treatment. Regarding PTSD symptom clusters, there was an interaction between positive affect levels and time on alterations in arousal and reactivity (AAR) cluster severity (b = −.01, p = .036); individuals with positive affect levels 1 SD above the mean (b = −.18, p < .01) and at the mean (b = −.10, p = .01) had greater decreases in AAR cluster severity across treatment compared with individuals with positive affect levels 1 SD below the mean (b = −.02, p = .710). Findings suggest that PPMT may relate to improved PTSD symptoms; and that positive affect levels/dysregulation may be worthwhile targets for future investigations.

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

Ellis,

Darnell,

Orcutt

2023

Journal of Traumatic Stress

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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.

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Perceived Barriers and Preliminary PTSD Outcomes in an Open Pilot Trial of Written Exposure Therapy With Latinx Immigrants

Cited by 14 publications

References 57 publications

Examining recipient and provider perceptions of mental health treatments and written exposure therapy for posttraumatic stress disorder with a Spanish-speaking sample.

Examining recipient and provider perceptions of mental health treatments and written exposure therapy for posttraumatic stress disorder with a Spanish-speaking sample.

Positive affect processes and posttraumatic stress disorder symptoms: Findings from an open label and uncontrolled pilot study using the positive memory processing technique.

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

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