STUB — A 5-session manualized writing protocol for PTSD developed by Denise Sloan and Brian Marx at the National Center for PTSD (Boston VA). Patient writes about the index trauma for ~30 minutes per session with brief therapist contact before and after. Imaginal exposure delivered in writing. Manual published by APA Press, 2nd edition.
How is WET different from expressive writing?
STUB — three core differences. First: WET is manualized exposure therapy with explicit imaginal-exposure instructions; expressive writing is open prompt without exposure mechanics. Second: WET requires therapist contact (brief but mandatory); expressive writing is solo. Third: WET's evidence base is in clinical PTSD; expressive writing's evidence is in subclinical distress. WET is not a longer Pennebaker protocol; it is a different therapy that uses writing as the delivery mechanism.
Does WET work as well as CPT or PE?
STUB — yes, by noninferiority. Sloan 2018 (n=126, JAMA Psychiatry): WET noninferior to 12-session CPT; WET dropout 6.4% vs CPT 39.7%. Sloan 2022 (active duty): noninferior to CPT. Sloan 2023 (n=178, JAMA Psychiatry): WET noninferior to PE. WET's symptom equivalence is real; the dropout differential may be the more clinically important finding.
Why is WET only 'Weak For' in the VA/DoD guideline if it's noninferior to first-line treatments?
STUB — procedural threshold. The VA/DoD 2023 CPG required ≥3 RCTs with active comparators using clinician-administered measures at the cutoff date; WET had fewer at that exact moment. A qualifying study was published immediately after. The 'Weak For' rating reflects the cutoff timing, not an evidence shortfall; the state-of-science review (PMC11700379, 2024) documents this.
Where can I find a WET-trained therapist?
STUB — the STRONG STAR Training Initiative (UT Health San Antonio) maintains the WET Learning Community: 2-day virtual workshop plus 12 consultation calls leads to Network Provider Status (no formal certification exists). Cost: $350. The list of trained providers is available through STRONG STAR.