Pretreatment Predictors of Dropout in War Veterans Receiving CBT for PTSD

Although research suggests that cognitive behavior therapy (CBT) is rather efficacious in the treatment of posttraumatic stress disorder (PTSD) symptoms, CBT also appears to be limited by high rates of treatment attrition. A recent retrospective study published in Psychological Services examined differences between war veterans (Iraq and Afghanistan) who completed treatment versus those who dropped out of treatment.

Participants (N = 117) in the present study received outpatient CBT treatment for PTSD at a PTSD specialty clinic. Their clinical data was evaluated, and the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) was utilized to predict treatment dropout. Dropout was defined as ending treatment before attaining the predetermined treatment goals set by the client and clinician.

According to results, approximately 68% of participants dropped out of treatment. Younger war Veterans were more likely to drop out from treatment than older veterans. Additionally, patients with high scores on MMPI-2 TRT scale, which measure discomfort with discussing problems and negative attitudes toward mental health treatment, were also more likely to drop out of treatment. Notably, war veterans who completed treatment showed reductions in PTSD symptom severity. These results suggest that age and negative attitudes toward mental health services can help predict treatment adherence in war veterans seeking treatment for PTSD.

Garcia, H. A., Kelley, L. P., Rentz, T. O., & Lee, S. (February 01, 2011). Pretreatment Predictors of Dropout From Cognitive Behavioral Therapy for PTSD in Iraq and Afghanistan War Veterans. Psychological Services, 8, 1, 1-11.

2 replies
  1. Mark Homer
    Mark Homer says:

    Have you considered using tapping to offer immediate reduction of anxiety, in hope of keeping the PTSD persons around long enough for training in CBT as a longer term strategy?

  2. Mike
    Mike says:

    Is it just the case that when CBT is not working for a client’s problems, the client drops out. If the CBT IS working then they stay.

    Therefore measuring the success rate based on those that stay is statistically unsound.

    However it seems positive for the 32% that complete treatment. Great news. I wonder if other treatments are needed for those that drop out? Maybe their PTSD is working in a different way?

    This is why psychiatric labels (like PTSD) are not useful, as every patient is different, and every patient with the same condition is also different. CBT only works for people with cognitive errors does it not? So any condition where that is not the root can not be resolved by CBT, am I right?


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