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

Authors

  • Verena Semmlinger Orcid
    Department of Psychology, LMU Munich, Munich, Germany
  • Keisuke Takano Orcid
    Human Informatics and Interaction Research Institute (HIIRI), National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan
  • Larissa Wolkenstein Orcid
    Department of Psychology, LMU Munich, Munich, Germany
  • Antje Krüger-Gottschalk Orcid
    Institute of Psychology, WWU Münster, Münster, Germany
  • Sascha Kuck Orcid
    Institute of Psychology, WWU Münster, Münster, Germany
  • Anne Dyer Orcid
    Central Institute of Mental Health, ZISG Mannheim, Mannheim, Germany
  • Andre Pittig Orcid
    Translational Psychotherapy, Institute of Psychology, Georg-August-University of Göttingen, Göttingen, Germany
  • Georg W. Alpers Orcid
    Department of Psychology, School of Social Science, University of Mannheim, Mannheim, Germany
  • Thomas Ehring Orcid
    Department of Psychology, LMU Munich, Munich, Germany; German Center for Mental Health (DZPG), Munich, Germany

Abstract

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