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

Although evidence-based interventions for posttraumatic stress disorder (PTSD) are highly effective, on average about 20% of patients drop out of treatment. Despite considerable research investigating PTSD treatment dropout in randomized controlled trials (RCTs), findings in naturalistic settings remain sparse.

Therefore, the present study investigated the frequency and predictors of dropout in trauma-focused interventions for PTSD in routine clinical care.

The sample included n = 195 adults with diagnosed PTSD, receiving trauma-focused, cognitive behavioral therapy in routine clinical care in three outpatient centers. We conducted a multiple logistic regression analysis with the following candidate predictors of dropout: patient variables (e.g., basic sociodemographic status and specific clinical variables) as well as therapist's experience level and gender match between therapist and patient.

Results showed a dropout rate of 15.38%. Age (higher dropout probability in younger patients) and living situation (living with parents predicted lower dropout probability compared to living alone) were significant predictors of dropout. Dropout was not significantly associated with the therapist's experience level and gender match.

In conclusion, routinely assessed baseline patient variables are associated with dropout. Ultimately, this may help to identify patients who need additional attention to keep them in therapy.