Written Exposure Therapy as Step One in Reducing the Burden of PTSD: The Composite Cases of "Alex," "Bruno," and "Charles"

The purpose of this study is to explore the effects of a stepped-care model of treatment on Posttraumatic Stress Disorder (PTSD) symptomatology and sequelae in United States' Veterans. The study provides a literature review of the burden of PTSD, describes current best treatment practices, and illustrates key processes in the service-delivery of these treatments. Treatment considerations are demonstrated via three hybrid case examples, which serve as vivid portrayals of Veteran clients who struggle with research-consistent PTSD symptomatology and difficulties engaging in psychotherapy. In addition to being informed by clinical examples in relevant psychological literature, these composite cases, "Alex," "Bruno," and "Charles," contain disguised aspects drawn from psychotherapy clients who have been in my caseload in a PTSD clinic. Demonstrating these clients