# Delivering Written Exposure Therapy for PTSD in Underserved Primary Care Settings

> **NIH NIH R01** · RAND CORPORATION · 2023 · $1,331,734

## Abstract

PROJECT SUMMARY
Posttraumatic stress disorder (PTSD) results in substantial costs to society is highly prevalent among adults.
Importantly, the prevalence PTSD within primary care settings is even higher than the general population as
primary care is the setting to which individuals with PTSD most often present. Evidence-based
psychotherapies (EBPs) for PTSD are available but dissemination within real world settings is fraught with
challenges because these therapies require 10-15, lengthy treatment sessions and extensive therapist training
to implement, and these treatments are not feasible within primary care settings given the limited time
resources. Consequently, there are multiple barriers to accessing EBPs for PTSD. Efforts to integrate mental
health services within primary care for PTSD though collaborative care management (CoCM) interventions are
rapidly expanding and have been shown to be effective in the treatment of depression and anxiety. However,
the evidence for PTSD is limited due to the time intensive nature of the PTSD therapy approaches that have
been examined. An efficient PTSD treatment approach is needed to address the treatment needs of individuals
with PTSD presenting to primary care. Written exposure therapy (WET) is a brief EBP that provides an
alternative to more intensive EBPs. Recent studies of WET have yielded positive outcomes and have shown it
to be non-inferior when directly compared to more time intensive PTSD EBPs, but WET has not yet been
examined within the primary care environment. The primary aims of the proposed study are to evaluate the
effectiveness and implementation of delivering WET into CoCM to improve the management of PTSD among
underserved primary care patients in Federally Qualified Health Centers (FQHCs). The pragmatic cluster-
randomized study will use a hybrid effectiveness-implementation design. Twelve FQHCs will be randomized to
either CoCM plus WET (CoCM+WET) or CoCM alone and 60 patients within each FQHC will be screened for
eligibility. We will use the RE-AIM framework (for Reach, Efficacy/Effectiveness, Adoption, Implementation, &
Maintenance) to evaluate the effectiveness and implementation process of the CoCM+WET intervention using
mixed methods. To examine effectiveness and potential mediators and moderators of the intervention, we will
administer assessments at baseline, 3- and 6-month follow-up. To assess implementation, we will use clinic
process data and clinic staff interviews pre- and post-intervention. This study has the potential to substantially
impact practice and public health by validating the effectiveness and feasibility of delivering a brief trauma-
focused EBP embedded within CoCM in primary care to improve PTSD outcomes for underserved patients.

## Key facts

- **NIH application ID:** 10657736
- **Project number:** 5R01MH123585-03
- **Recipient organization:** RAND CORPORATION
- **Principal Investigator:** Lisa Seidel Meredith
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $1,331,734
- **Award type:** 5
- **Project period:** 2021-09-13 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10657736

## Citation

> US National Institutes of Health, RePORTER application 10657736, Delivering Written Exposure Therapy for PTSD in Underserved Primary Care Settings (5R01MH123585-03). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10657736. Licensed CC0.

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