Universiteit Leiden

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Research project

Cost-Effectiveness of Written Exposure Therapy for Post-Traumatic Stress Symptoms – a Randomised Controlled Trial (RCT)

The STAP study examines the cost-effectiveness of Written Exposure Therapy (WET) for post-traumatic stress disorder (PTSD) symptoms in primary care settings.

Duration
2025 - 2030
Contact
Joanne Mouthaan
Funding
ZonMW ZonMW
Partners

LUMC, GGZ Noord-Holland Noord, Rijn en Duin, Vicino

Scientific background

Post-traumatic stress disorder (PTSD) is a common mental health condition that can develop following exposure to traumatic events. Although effective treatments are available, many patients face barriers such as long waiting times for specialist care and limited access to evidence-based interventions.

In the Netherlands, individuals experiencing PTSD symptoms are often first seen by their general practitioner (GP) and receive support from the Mental Health Practice Nurse (Praktijkondersteuner Huisarts Geestelijke Gezondheidszorg, POH-GGZ). Written Exposure Therapy (WET) is a brief, structured, and evidence-based writing intervention for PTSD that has demonstrated efficacy in specialist mental health care (Specialistische Geestelijke Gezondheidszorg, SGGZ).

The STAP study, funded by ZonMW, investigates whether WET can also be effectively and cost-effectively delivered by POH-GGZ professionals in primary care, with supervision and support from specialist services.

Research objectives

The STAP study aims to enhance the accessibility and effectiveness of care for patients with post-traumatic stress disorder (PTSD) by investigating the implementation of Written Exposure Therapy (WET) in general practice. The specific objectives are to:

  1. Evaluate the effectiveness of WET compared with usual care in reducing PTSD symptoms and improving quality of life.
  2. Examine the cost-effectiveness of WET in terms of healthcare and societal costs.
  3. Develop an implementation model for WET in general practice.
  4. Promote interdisciplinary collaboration among general practitioners, mental health practice nurses (POH-GGZ), psychologists, implementation experts, and health economists.

Study design and methods

Study design
The STAP study is a randomised controlled trial (RCT) in which 176 adults experiencing post-traumatic stress symptoms are randomly assigned to either Written Exposure Therapy (WET) or treatment as usual. The study is conducted in general practices across two regions in the Netherlands: Zuid-Holland Noord and Noord-Holland Noord.

Methods
Written Exposure Therapy consists of six weekly writing sessions delivered by mental health practice nurses (POH-GGZ), with supervision and support from specialist mental health services (SGGZ). Key outcome measures include reduction in PTSD symptoms, improvement in quality of life, and cost-effectiveness. Data collection involves quantitative assessments, including cost analyses and an evaluation of the implementation process.

Contact

STAP@fsw.leidenuniv.nl via Project Manager Joanne Mouthaan

Strategic Priorities

Translational, Interdisciplinarity

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