Date of Award


Degree Name

Doctor of Philosophy



First Advisor

Amy E. Naugle, Ph.D.

Second Advisor

Scott T. Gaynor, Ph.D.

Third Advisor

Jessica Rodriguez, Ph.D.

Fourth Advisor

Brooke Smith, Ph.D.


Exposure, journaling, PTSD, telehealth, trauma, WET


The COVID-19 pandemic has disproportionately impacted individuals with mental health issues (Swendsen, 2020). Although the peak destruction of the COVID-19 pandemic has passed, the psychological fallout remains. Social isolation, home confinement, and travel restrictions have exacerbated mental health issues during the COVID-19 pandemic, contributing to negative psychological distress (Smith et al., 2020). Survivors of trauma have higher vulnerability to prolonged psychological distress than the general population and others with non-trauma-related mental health conditions, which has been exacerbated during and following the COVID-19 pandemic. For these reasons, survivors of trauma may particularly benefit from virtual-delivery of trauma-focused treatments. Mental health providers have adapted to the need for telehealth services, delivering previously in-person evidence-based treatments through video-conferencing platforms. Written Exposure Therapy (WET) is a structured and partly scripted five session weekly mental health treatment designed to treat posttraumatic stress symptoms (Sloan & Marx, 2019). The goal of the current study was to investigate whether WET delivered virtually, through videoconferencing services, is efficacious in the reduction of psychological symptoms in individuals who have experienced a traumatic event. Twenty-six individuals completed a full dose of WET. Mean reductions in the per-protocol sample (n = 26) at five-weeks were 29.5 points on the PCL-5 (CI 25.4, 33.6; Cohen’s d = 2.95), 7.3 points on the PHQ-9 (CI 5.3, 9.3, d = 1.40), and 6.7 points on the ISI (CI 4.6, 8.8, d= 1.20), which were maintained at two-month follow-up. A repeated-measures ANOVA was utilized to estimate treatment effect (η2 p=0.88). All 26 participants ( 100%) experienced clinically meaningful reductions in PTSD symptoms by the end of treatment. These findings suggest that WET, especially when adapted to a telehealth format, seems to be a promising treatment option for individuals with significant posttraumatic stress symptoms, irrespective of trauma type.

Access Setting

Dissertation-Open Access