Treatment outcomes for military-affiliated clients with posttraumatic stress disorder in a community mental health network

Treating posttraumatic stress disorder (PTSD) in military-affiliated populations, including veterans, active duty service members, and their families, remains a significant challenge in the mental health field. Most research on PTSD treatment outcomes has been conducted in controlled trials or within VA and military settings, limiting its generalizability to other clinical environments. This study examined treatment outcomes for 2,717 military-affiliated clients receiving treatment for PTSD within a community mental health network. Treatments included cognitive processing therapy (CPT), eye movement desensitization and reprocessing (EMDR), or prolonged exposure (PE), with outcomes measured using the PTSD Checklist for DSM-5 (PCL-5) throughout treatment. Clients who attended at least four sessions showed substantial symptom reductions for CPT (ΔM = 19.3), d = 0.98; EMDR (ΔM = 16.6), d = 0.86; and PE (ΔM = 17.4), d = 0.87, all of which exceeded improvements seen with other treatments (ΔM = 12.6), d = 0.71. Analyses of clinically meaningful change thresholds showed similar results across treatments, with 51.9% of CPT, 47.8% of EMDR, and 53.1% of PE clients experiencing a PCL-5 score reduction of at least 18 points after four or more sessions. Dropout prior to four sessions was notable, with 27.5%-40.1% of clients across treatment groups discontinuing treatment before reaching this threshold. Overall, the findings provide real-world evidence supporting the effectiveness of CPT, EMDR, and PE in military-affiliated populations and validate their continued use in community mental health settings.