Written Exposure Therapy
Core Mechanism
Brief written exposure to trauma memory without homework or processing produces habituation and cognitive change (proposed)
Ontology
Same fear structure model as PE; written narrative activates and modifies trauma memory
Therapeutic Voice
"Write about the worst moment of the trauma for 30 minutes. Include every detail you remember."
View of the Person
A narrative being who can process trauma through written confrontation with the memory
Evidence
VA/DoD 2023: Suggested (weak for) PTSD
3+ RCTs
Included in PTSD meta-analyses
VA/DoD 2023 suggests WET. Attractive for efficiency.
Conditions
Epistemology
Blind Spots
Very brief protocol may be insufficient for complex presentations; limited therapist contact compared to PE
Contraindications
Active psychosis, severe dissociation, clients unable to write or with severe literacy limitations, acute suicidality, clients who require the relational support of verbal trauma processing
Training
5-session manualized protocol. Graduate trauma training + manual sufficient
No formal certification
4-8 hrs; manual study
Minimal
Philosophical Roots
Same theoretical base as PE (Foa — emotional processing); Pennebaker (expressive writing research); narrative psychology (writing organizes experience)
Related Modalities
Test Yourself
How does WET differ from PE?
Show answer
Only 5 writing sessions vs 8-15. No homework, no in-vivo exposure.