Dropout From Trauma-Focused Treatment for PTSD in a Naturalistic Setting

Area of Science:

• Psychiatry
• Clinical Psychology
• Mental Health Services Research

Background:

• Evidence-based treatments for posttraumatic stress disorder (PTSD) are effective, yet approximately 20% of patients discontinue therapy.
• Research on PTSD treatment dropout is abundant in randomized controlled trials (RCTs), but scarce in naturalistic clinical settings.

Purpose of the Study:

• To determine the frequency and predictors of dropout in trauma-focused interventions for PTSD within routine clinical care.
• To identify patient and therapist factors associated with treatment discontinuation in a real-world clinical environment.

Main Methods:

• A sample of 195 adults diagnosed with PTSD receiving trauma-focused cognitive behavioral therapy in outpatient centers was analyzed.
• Multiple logistic regression was employed to examine predictors of dropout, including patient demographics, clinical variables, therapist experience, and therapist-patient gender match.

Main Results:

• The observed dropout rate was 15.38%.
• Younger age and living alone were significant predictors of higher dropout probability.
• Therapist experience and gender match did not significantly predict dropout.

Conclusions:

• Routinely collected baseline patient variables are associated with dropout from PTSD treatment.
• Identifying at-risk patients based on sociodemographic factors can help tailor interventions to improve treatment adherence.