Practically Speaking: Behind the Episode: “WETting” Our Toes in Trauma Treatment Options”
One of the issues that all providers are faced with in their clinical practice is deciding what treatment options might fit best with a client who has PTSD. While our brains often go to the first line treatments like PE, CPT and EMDR, sometimes a 10 - 12 session protocol isn't the best fit for the client in front of us who can’t commit to that treatment length or has other reasons that drive a different approach. To truly provide patient-driven care, we, as clinicians, need to have other EBP options at-the-ready to meet our clients where they are. In this episode of Practical for your Practice, CDP’s own Dr. Paula Domenici joins us to talk about her experience with using Written Exposure Therapy (WET) and how it has enhanced her clinical practice.
Click here to listen to the episode! "'WET-ting' Our Toes in Trauma Treatment Options"
We asked Dr. Domenici why she opted to seek out training in WET. “I felt like it was really important to learn another evidence-based PTSD treatment that was kind of up and coming and I had heard had a lot of promise and what was probably most appealing about it, from what I'd heard is that it was brief and no homework. I thought it might be a nice addition to my toolbox because not everybody wants to do prolonged exposure therapy for example… That it might not be sellable to a certain subset of PTSD clients, when in fact we want to give them the best treatment options possible. If they won't go for the gold standards, let's kind of look down to the next level and have it at-the-ready to provide to them. And so, what I have found is that I'm really grateful that I have it as one other kind of tool, one other intervention to use with patients with PTSD… particularly if they're not inclined to use an evidence-based therapy like prolonged exposure therapy – that I have something else that's not just stress management nor just supportive counseling and has growing research to support it.”
Written Exposure Therapy is a brief, 5 session psychotherapy. Similar to other EBPs for PTSD, the protocol includes psychoeducation about PTSD, but the main treatment component involves the client writing a trauma narrative (30 min) in session with a brief discussion about the experience of writing about the trauma with the therapist afterward. This narrative is reviewed by the provider between sessions but only to offer more precise instructions for writing the narrative in subsequent weeks. Over time, the goal is for patients to learn to manage thoughts and feelings about the events and incorporate new meanings that help to reduce symptoms of PTSD. On the surface, WET can sound simplistic, perhaps even too good to be true. Dr. Domenici shares that she had just these sorts of doubts, “I definitely was skeptical. I thought it might work with someone with a one-time trauma, what we call a simple trauma, not a chronic PTSD. It almost seemed magical, too good to be true.” But once she gave it a try, Dr. Domenici’s skepticism turned to seeing WET as a promising approach for certain types of patients.
If you are interested in hearing more about how both Dr. Domenici and co-host Dr. Lefkowitz have used WET in their clinical practice to include case examples, take a listen and come dip your toes with us as we explore how WET might be a good protocol to add to your clinical toolbox. You won’t want to miss Paula’s “EBP Confession” so stay tuned in until the end! Until next time…
Click here to listen to the episode! "'WET-ting' Our Toes in Trauma Treatment Options"
The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of Defense.
Kevin Holloway, Ph.D., is a licensed clinical psychologist working as Director of Online Training, Technology and Telehealth at the Center for Deployment Psychology (CDP) at the Uniformed Services University of the Health Sciences in Bethesda, Maryland.
One of the issues that all providers are faced with in their clinical practice is deciding what treatment options might fit best with a client who has PTSD. While our brains often go to the first line treatments like PE, CPT and EMDR, sometimes a 10 - 12 session protocol isn't the best fit for the client in front of us who can’t commit to that treatment length or has other reasons that drive a different approach. To truly provide patient-driven care, we, as clinicians, need to have other EBP options at-the-ready to meet our clients where they are. In this episode of Practical for your Practice, CDP’s own Dr. Paula Domenici joins us to talk about her experience with using Written Exposure Therapy (WET) and how it has enhanced her clinical practice.
Click here to listen to the episode! "'WET-ting' Our Toes in Trauma Treatment Options"
We asked Dr. Domenici why she opted to seek out training in WET. “I felt like it was really important to learn another evidence-based PTSD treatment that was kind of up and coming and I had heard had a lot of promise and what was probably most appealing about it, from what I'd heard is that it was brief and no homework. I thought it might be a nice addition to my toolbox because not everybody wants to do prolonged exposure therapy for example… That it might not be sellable to a certain subset of PTSD clients, when in fact we want to give them the best treatment options possible. If they won't go for the gold standards, let's kind of look down to the next level and have it at-the-ready to provide to them. And so, what I have found is that I'm really grateful that I have it as one other kind of tool, one other intervention to use with patients with PTSD… particularly if they're not inclined to use an evidence-based therapy like prolonged exposure therapy – that I have something else that's not just stress management nor just supportive counseling and has growing research to support it.”
Written Exposure Therapy is a brief, 5 session psychotherapy. Similar to other EBPs for PTSD, the protocol includes psychoeducation about PTSD, but the main treatment component involves the client writing a trauma narrative (30 min) in session with a brief discussion about the experience of writing about the trauma with the therapist afterward. This narrative is reviewed by the provider between sessions but only to offer more precise instructions for writing the narrative in subsequent weeks. Over time, the goal is for patients to learn to manage thoughts and feelings about the events and incorporate new meanings that help to reduce symptoms of PTSD. On the surface, WET can sound simplistic, perhaps even too good to be true. Dr. Domenici shares that she had just these sorts of doubts, “I definitely was skeptical. I thought it might work with someone with a one-time trauma, what we call a simple trauma, not a chronic PTSD. It almost seemed magical, too good to be true.” But once she gave it a try, Dr. Domenici’s skepticism turned to seeing WET as a promising approach for certain types of patients.
If you are interested in hearing more about how both Dr. Domenici and co-host Dr. Lefkowitz have used WET in their clinical practice to include case examples, take a listen and come dip your toes with us as we explore how WET might be a good protocol to add to your clinical toolbox. You won’t want to miss Paula’s “EBP Confession” so stay tuned in until the end! Until next time…
Click here to listen to the episode! "'WET-ting' Our Toes in Trauma Treatment Options"
The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of Defense.
Kevin Holloway, Ph.D., is a licensed clinical psychologist working as Director of Online Training, Technology and Telehealth at the Center for Deployment Psychology (CDP) at the Uniformed Services University of the Health Sciences in Bethesda, Maryland.