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Beyond Binary Thinking: Providing Best Practice Treatment to Veterans with PTSD

David J. Austern

Abstract


In "Written Exposure Therapy as Step One in Reducing the Burden of PTSD: The Composite Cases of "Alex,' 'Bruno,' and 'Charles'"(Austern, 2017), I presented three composite case study examples of how veterans suffering from PTSD may benefit from written exposure to their trauma memories. For one case (Bruno), Written Exposure Therapy (WET) was the initial treatment in a stepped-care approach that culminated in Prolonged Exposure therapy. However, for the two others, WET became a standalone treatment. In two commentaries on the cases, Cigrang and Peterson (2017) and Sloan and Marx (2017) discuss the development and efficacy of WET, WET implementation strategies, and practice implications of WET (e.g., the potential to reduce clinician burnout). In my response to these commentaries, I aim to contribute to the bourgeoning discussion of how mental health providers can best incorporate this promising writing-based treatment (WET) into their existing approaches to working with veterans suffering from Post-Traumatic Stress Disorder (PTSD). My response will address themes raised by my composite case studies and by the commentaries, including how stepped-care service delivery models may have the potential to make PTSD care more efficient.

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