Written Exposure Therapy Boosts Recovery Capital in SUD and PTSD

Key Clinical Summary

• Written Exposure Therapy (WET) combined with treatment as usual (TAU) improved recovery capital in patients with posttraumatic stress disorder (PTSD) and substance use disorders (SUD) in a randomized controlled trial.
• Significant gains on the Brief Assessment of Recovery Capital (BARC-10) were observed in both the WET and TAU groups, whereas pairwise comparisons by condition showed more improvement in the WET plus TAU group.
• Findings support integrating brief, evidence-based PTSD treatment into short-term residential addiction care settings.

New randomized controlled trial data presented at the American Society of Addiction Medicine (ASAM) 57th Annual Conference in San Diego, California, highlighted the benefits of integrating Written Exposure Therapy (WET) into residential substance use disorder (SUD) treatment. The study demonstrated that adding a brief posttraumatic stress disorder (PTSD) intervention to standard care significantly improved recovery capital, a key determinant of sustained addiction recovery.

WET involves 5 sessions lasting 45 to 60 minutes, during which patients are re-exposed to the traumatic event through structured writing exercises.

Poster Highlights

Kevin R. Wenzel, PhD, Director of Research at Maryland Treatment Centers/Mountain Manor, presented findings from a parallel-group randomized superiority trial evaluating treatment as usual (TAU) versus TAU plus WET in adults with co-occurring PTSD and SUD (n = 42). WET consisted of five 45 to 60-minute sessions using structured trauma-focused writing exercises delivered during residential care.

Recovery capital was measured using the Brief Assessment of Recovery Capital (BARC-10), a validated 10-item scale assessing psychosocial, physical, and environmental recovery resources. Mixed methods analyses showed a significant time effect (F(1,40) = 15.63, p < .001, np2 = .28) and a significant condition-by-time interaction (F(1,40) = 4.33, p = .044, np2 = .10). In pairwise comparisons by condition, participants receiving WET plus usual care demonstrated greater improvements in BARC-10 scores compared with usual care alone (mean difference = 5.40, p = .042, 95% CI [-10.60, -0.20]).

Importantly, only the WET group showed significant pre- to post-treatment improvement (mean difference = 7.84, p < .001), whereas the usual care group did not achieve statistically significant change. Treatment completion was high, with 75% of participants completing all 5 sessions.

Expert Perspectives

“The results of our pilot randomized trial suggest that Written Exposure Therapy can be implemented successfully during an inpatient addiction treatment episode lasting just 2 to 3 weeks, effectively reduce PTSD symptoms, and improve recovery capital compared to usual care alone,” Dr Wenzel told Psych Congress Network via email.

He noted that improvements in recovery capital were unexpected, as the intervention does not directly target recovery capital. “Overall, the results reinforce the converging evidence that PTSD can be treated concurrently with SUD and suggest WET is a good option for inpatient addiction treatment settings.”

Implications for Practice

These results highlight the clinical value of integrating brief, evidence-based PTSD into residential SUD programs. Written Exposure Therapy’s low burden, lack of homework, and flexible delivery make it feasible for short-term settings. Improvements in recovery capital suggest broader benefits beyond symptom reduction, potentially enhancing long-term recovery outcomes.

Reference

Wenzel KR, Schacht RL, and Fishman M. Written exposure therapy for PTSD increases recovery capital for adults with SUD. Poster presented at ASAM Annual Conference; April 23-26, 2026; San Diego, California.