Written Exposure Therapy for PTSD Integrated with Cognitive Behavioral Coping Skills for Cannabis Use Disorder After Recent Sexual Assault: A Case Series

<b>Background/Objectives</b>: The co-occurrence of posttraumatic stress disorder (PTSD) and cannabis use disorder (CUD) symptoms is common following sexual assault, particularly among emerging adult women. CUD is associated with more severe PTSD symptoms and other mental health comorbidi...

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Main Authors: Christine K. Hahn, Selime R. Salim, Emily L. Tilstra-Ferrell, Kathleen T. Brady, Brian P. Marx, Barbara O. Rothbaum, Michael E. Saladin, Constance Guille, Amanda K. Gilmore, Sudie E. Back
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Behavioral Sciences
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Online Access:https://www.mdpi.com/2076-328X/15/7/877
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author Christine K. Hahn
Selime R. Salim
Emily L. Tilstra-Ferrell
Kathleen T. Brady
Brian P. Marx
Barbara O. Rothbaum
Michael E. Saladin
Constance Guille
Amanda K. Gilmore
Sudie E. Back
author_facet Christine K. Hahn
Selime R. Salim
Emily L. Tilstra-Ferrell
Kathleen T. Brady
Brian P. Marx
Barbara O. Rothbaum
Michael E. Saladin
Constance Guille
Amanda K. Gilmore
Sudie E. Back
author_sort Christine K. Hahn
collection DOAJ
description <b>Background/Objectives</b>: The co-occurrence of posttraumatic stress disorder (PTSD) and cannabis use disorder (CUD) symptoms is common following sexual assault, particularly among emerging adult women. CUD is associated with more severe PTSD symptoms and other mental health comorbidities including depression, suicidality, and emotion dysregulation. Addressing these issues concurrently soon after sexual assault could help decrease the risk for downstream negative health outcomes. Integrated trauma-focused interventions for PTSD and co-occurring substance use disorders have been shown to decrease PTSD severity and substance use. Yet, existing protocols are lengthy and have rarely been applied following recent trauma exposure or specifically to address CUD symptoms. <b>Methods</b>: This case series describes the application of Written Exposure Therapy (WET) for PTSD adapted to integrate cognitive-behavioral skills training for substance use among women following recent sexual assault. The adapted integrated intervention, Skills Training and Exposure for PTSD and Substance Misuse (STEPS), was delivered to three emerging adult women (age range = 19–25) who experienced recent sexual assault (weeks since assault range = 1–12 weeks). <b>Results</b>: This case series describes the novel intervention and examines clinical outcomes post-treatment and at the 1-month follow-up. Past-week PTSD symptoms (based on a clinical interview) and past-month cannabis use decreased among all participations after receiving STEPS. <b>Conclusions</b>: Preliminary findings from the case series provide new knowledge and insights regarding the application of STEPS following recent sexual assault among individuals with co-occurring PTSD and CUD. Therapeutic strategies for addressing PTSD and CUD concurrently and implications for future clinical research are discussed.
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spelling doaj-art-fdf86b33db444bd586eff2b1169ced462025-08-20T03:36:15ZengMDPI AGBehavioral Sciences2076-328X2025-06-0115787710.3390/bs15070877Written Exposure Therapy for PTSD Integrated with Cognitive Behavioral Coping Skills for Cannabis Use Disorder After Recent Sexual Assault: A Case SeriesChristine K. Hahn0Selime R. Salim1Emily L. Tilstra-Ferrell2Kathleen T. Brady3Brian P. Marx4Barbara O. Rothbaum5Michael E. Saladin6Constance Guille7Amanda K. Gilmore8Sudie E. Back9Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, 67 President St. Suite 861, Charleston, SC 29425, USADepartment of Psychiatry & Behavioral Sciences, Medical University of South Carolina, 67 President St. Suite 861, Charleston, SC 29425, USADepartment of Psychiatry & Behavioral Sciences, Medical University of South Carolina, 67 President St. Suite 861, Charleston, SC 29425, USADepartment of Psychiatry & Behavioral Sciences, Medical University of South Carolina, 67 President St. Suite 861, Charleston, SC 29425, USADepartment of Psychiatry, Boston University School of Medicine, 720 Harrison Avenue, Boston, MA 02118, USAEmory School of Medicine, Emory University, 01 Dowman Dr., Atlanta, GA 30322, USADepartment of Psychiatry & Behavioral Sciences, Medical University of South Carolina, 67 President St. Suite 861, Charleston, SC 29425, USADepartment of Psychiatry & Behavioral Sciences, Medical University of South Carolina, 67 President St. Suite 861, Charleston, SC 29425, USADepartment of Health Policy and Behavioral Sciences, Mark Chaffin Center for Healthy Development, School of Public Health, Georgia State University, Atlanta, GA 30303, USADepartment of Psychiatry & Behavioral Sciences, Medical University of South Carolina, 67 President St. Suite 861, Charleston, SC 29425, USA<b>Background/Objectives</b>: The co-occurrence of posttraumatic stress disorder (PTSD) and cannabis use disorder (CUD) symptoms is common following sexual assault, particularly among emerging adult women. CUD is associated with more severe PTSD symptoms and other mental health comorbidities including depression, suicidality, and emotion dysregulation. Addressing these issues concurrently soon after sexual assault could help decrease the risk for downstream negative health outcomes. Integrated trauma-focused interventions for PTSD and co-occurring substance use disorders have been shown to decrease PTSD severity and substance use. Yet, existing protocols are lengthy and have rarely been applied following recent trauma exposure or specifically to address CUD symptoms. <b>Methods</b>: This case series describes the application of Written Exposure Therapy (WET) for PTSD adapted to integrate cognitive-behavioral skills training for substance use among women following recent sexual assault. The adapted integrated intervention, Skills Training and Exposure for PTSD and Substance Misuse (STEPS), was delivered to three emerging adult women (age range = 19–25) who experienced recent sexual assault (weeks since assault range = 1–12 weeks). <b>Results</b>: This case series describes the novel intervention and examines clinical outcomes post-treatment and at the 1-month follow-up. Past-week PTSD symptoms (based on a clinical interview) and past-month cannabis use decreased among all participations after receiving STEPS. <b>Conclusions</b>: Preliminary findings from the case series provide new knowledge and insights regarding the application of STEPS following recent sexual assault among individuals with co-occurring PTSD and CUD. Therapeutic strategies for addressing PTSD and CUD concurrently and implications for future clinical research are discussed.https://www.mdpi.com/2076-328X/15/7/877cannabisposttraumatic stress disordersexual assaultintegrated intervention
spellingShingle Christine K. Hahn
Selime R. Salim
Emily L. Tilstra-Ferrell
Kathleen T. Brady
Brian P. Marx
Barbara O. Rothbaum
Michael E. Saladin
Constance Guille
Amanda K. Gilmore
Sudie E. Back
Written Exposure Therapy for PTSD Integrated with Cognitive Behavioral Coping Skills for Cannabis Use Disorder After Recent Sexual Assault: A Case Series
Behavioral Sciences
cannabis
posttraumatic stress disorder
sexual assault
integrated intervention
title Written Exposure Therapy for PTSD Integrated with Cognitive Behavioral Coping Skills for Cannabis Use Disorder After Recent Sexual Assault: A Case Series
title_full Written Exposure Therapy for PTSD Integrated with Cognitive Behavioral Coping Skills for Cannabis Use Disorder After Recent Sexual Assault: A Case Series
title_fullStr Written Exposure Therapy for PTSD Integrated with Cognitive Behavioral Coping Skills for Cannabis Use Disorder After Recent Sexual Assault: A Case Series
title_full_unstemmed Written Exposure Therapy for PTSD Integrated with Cognitive Behavioral Coping Skills for Cannabis Use Disorder After Recent Sexual Assault: A Case Series
title_short Written Exposure Therapy for PTSD Integrated with Cognitive Behavioral Coping Skills for Cannabis Use Disorder After Recent Sexual Assault: A Case Series
title_sort written exposure therapy for ptsd integrated with cognitive behavioral coping skills for cannabis use disorder after recent sexual assault a case series
topic cannabis
posttraumatic stress disorder
sexual assault
integrated intervention
url https://www.mdpi.com/2076-328X/15/7/877
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