(PS11-A20) Preliminary Evidence for the Effectiveness of Single-session Written Exposure Therapy for Posttraumatic Stress Symptoms in a College Sample

Single session interventions, though brief, may lead to clinically significant improvement, making mental health treatment more accessible (Henry et al., 2010; Lancaster et al., 2015; Schleider et al., 2021; Slavin-Spenny et al., 2011). The use of telehealth has also been effective in addressing accessibility (Barbosa et al., 2021; Sugarman et al., 2021). However, many factors still affect access, including ability to attend weekly sessions, restricted business hours, long wait times, and stigma associated with treatment (Hodgkinson et al., 2017). The current study sought to determine whether a brief self-compassion intervention would increase the effectiveness of a single-session of Written Exposure Therapy (WET; Sloan & Marx, 2019) for posttraumatic stress symptoms (PTSS) with a secondary goal of evaluating the efficacy of a single WET session overall. This study recruited introductory psychology students at a large Midwestern university who had experienced a traumatic event. Eligibility criteria consisted of scoring 20 or higher on the PCL-5 (Weathers et al., 2013) and a lack of suicidal ideation. The final sample (n = 47) was predominately female-identifying (75.5%) and racially/ethnically diverse (42.6% White), with an average age of 19.46. Participants were randomly assigned to an exposure-only or a self-compassion-with-exposure condition. This condition involved listening to a five-minute self-compassion break prior to engaging in the same exposure task. All participants completed measures in-person prior to presentation of the WET session #1 prompt. At a two-week follow-up (in-person or online), participants completed the PCL-5 again with the hypotheses that participants would demonstrate a statistically significant improvement in PCL-5 scores regardless of condition, and that improvement would be greater in the self-compassion condition.

            The average baseline PTSS across the sample was 35.548 (SD = 10.769). A paired t-test indicated that participants across the sample demonstrated a significant reduction in PCL-5 scores at follow-up (t(46) = -11.081, p < .01). Across the sample, the average PCL-5 score at follow-up was 27.531 (SD = 16.080). A mediation analysis using PROCESS model 6 (Hayes, 2022) indicated that, while in the expected direction, there was no significant total effect (B = -0.073, p = .986, 95% CI [-8.225, 8.079]) nor indirect effect (B = -0.052, 95% CI [-0.677, 0.391]) of the self-compassion break on follow-up PCL-5 scores. The  reduction of PCL-5 symptoms in the current study further supports WET as an efficacious intervention for reducing PTSD symptoms alongside previous WET studies but in a non-military (college) sample (Rauch & Rothbaum, 2016; Sloan et al., 2021). The results of this study also suggest the possibility that a single session of WET can be effective in reducing PTSS above and beyond natural recovery. However, the lack of a non-WET comparison group precludes definitive conclusions due to possible regression to the mean, a significant limitation of the study. If a single session intervention of WET is shown to be effective, the use of this intervention may be helpful for individuals with both PTSS and resource barriers to achieve clinically significant outcomes.