Written Exposure Therapy (WET)
A practical guide to Written Exposure Therapy: a brief, 5-session treatment for PTSD that uses structured writing about traumatic experiences.
What Is Written Exposure Therapy?
Written Exposure Therapy (WET) is a brief, evidence-based treatment for PTSD developed by psychologist Denise Sloan and colleagues at the National Center for PTSD and Boston University. WET distills the core elements of exposure therapy into a remarkably efficient format: just five sessions, each lasting 40 to 60 minutes, with no homework between sessions.
WET is based on the same emotional processing theory that underpins Prolonged Exposure — the idea that avoidance of trauma-related memories maintains PTSD, and that engaging with those memories in a structured way allows them to be processed. However, WET accomplishes this through writing rather than verbal recounting, and it does so in far fewer sessions than traditional exposure therapies.
WET was developed in response to a practical reality: many people with PTSD do not complete longer treatments. Dropout rates for evidence-based PTSD therapies typically range from 18-36%. By creating a brief, low-burden treatment, WET aims to help more people complete therapy and recover.
How It Works
WET follows a simple, structured protocol across five sessions.
Session 1
The first session includes psychoeducation about PTSD and the rationale for written exposure. Your therapist explains that avoidance keeps PTSD going and that writing about the trauma will help you process it. You then receive specific writing instructions and spend 30 minutes writing about your index trauma — the traumatic event most closely connected to your current symptoms.
The writing instructions for the first session ask you to describe what happened during the traumatic event, including your thoughts and feelings during and after the event. You are asked to write continuously, without worrying about grammar, spelling, or coherence.
Sessions 2-5
In each subsequent session, you spend 30 minutes writing about the same traumatic event. However, the writing instructions shift across sessions. You are gradually asked to focus more deeply on the meaning of the event — what it means about you, others, and the world — and on your deepest thoughts and feelings about the experience.
After each writing session, your therapist briefly checks in with you (about 10 minutes), but there is no formal processing, cognitive restructuring, or homework. The writing itself is the intervention.
Your therapist does not read what you have written unless you choose to share it. This can make WET feel safer for people who are uncomfortable sharing trauma details verbally.
5
What to Expect
WET sessions are structured and predictable. You arrive, receive your writing instructions, write for 30 minutes, and then have a brief check-in with your therapist. Sessions are held weekly, so the full treatment takes just five weeks.
The writing can be emotionally activating, particularly in the first two sessions. It is normal to feel distressed during and immediately after writing. However, most people find that the distress decreases across sessions as the memory is processed. Your therapist will monitor your well-being throughout.
Between sessions, there is no homework — no recordings to listen to, no worksheets to complete, no in vivo exposure assignments. This low burden is one of WET's major advantages for people whose PTSD symptoms make it difficult to follow through with between-session tasks.
Conditions It Treats
WET is specifically designed for PTSD and has been validated for PTSD resulting from:
- Military combat
- Sexual assault
- Physical assault
- Motor vehicle accidents
- Other traumatic events
WET also reduces co-occurring depression symptoms. It is appropriate for adults with PTSD; research on its use with adolescents is still developing.
Effectiveness
The pivotal study establishing WET's effectiveness was a 2018 randomized controlled trial published in JAMA Psychiatry by Sloan, Marx, Lee, and Resick. This trial compared WET directly to Prolonged Exposure (the gold standard) and found that WET was non-inferior — meaning it produced comparable PTSD symptom reductions despite being far briefer and less intensive. Importantly, WET had a significantly lower dropout rate (6%) compared to PE (39%).
A subsequent study confirmed these findings and demonstrated that WET's benefits were maintained at follow-up. WET is now recognized as an evidence-based treatment for PTSD and has been adopted by the VA healthcare system.
Compared to Prolonged Exposure, WET is dramatically briefer (5 vs. 8-15 sessions), requires no homework, and has lower dropout rates, while producing comparable symptom reduction. PE offers more therapist guidance and processing, which some people prefer. Compared to CPT, WET is briefer and less cognitively demanding — it does not require learning cognitive restructuring techniques — but CPT provides more tools for ongoing cognitive change. The choice depends on individual needs and preferences.
No. Your therapist does not read your writing unless you choose to share it. This is by design — the therapeutic benefit comes from the act of writing itself, not from the therapist reviewing the content. Some people find this privacy makes WET feel safer than verbal exposure.
The instruction is to write continuously for 30 minutes, but if you get stuck, you are encouraged to simply re-read what you have written and continue from there, or to write about your thoughts and feelings in the moment. There is no need for polished or coherent writing.
Research shows that yes, for many people, 5 sessions of WET produces PTSD symptom reductions comparable to longer treatments like Prolonged Exposure. However, not everyone responds to every treatment, and your therapist can discuss alternative or additional options if needed.
WET focuses on a single index trauma — the event most closely connected to your current PTSD symptoms. Processing this primary trauma often leads to improvement in symptoms related to other events as well. If significant symptoms remain, additional treatment can be considered.