2 - (SYM 82) Achieving Low Levels of Dropout During Intensive PTSD Treatment: Data from Multiple Length and Multiple Format Intensive CPT Interventions

The number of trauma survivors who complete full courses of highly efficacious evidence-based PTSD treatments, such as Cognitive Processing Therapy (CPT), is estimated to be around 71% for clinical trials and 30-65% for clinical programs. Generally, greater severity of symptoms, in particular avoidance symptoms, is associated with lower likelihood of completing a full course of therapy. Additionally, studies often reported that logistical barriers, such as work or family conflicts or limited provider availability, are associated with greater attrition. Most studies concerning dropout from PTSD treatment have been conducted within the Veterans Health Administration (VHA), limiting knowledge about dropout in other settings and populations. Additionally, research literature concerning CPT dropout typically addresses traditionally delivered (i.e., once weekly) therapy sessions. Newer findings suggest that intensively delivered CPT (i.e., daily) is related to lower dropout rates than traditionally delivered treatment.

This study examined dropout rates across several non-VHA, intensive-CPT treatment programs as well as standalone CPT interventions delivered intensively. A 3-week in-person intensive PTSD treatment program (ITP) for veterans (N = 578) that included daily CPT and adjunctive groups and services including mindfulness, yoga, and psychoeducation, had an 88% completion rate. A 2-week version of the same veterans ITP (N = 470) resulted in a 94% completion rate, and a small virtual trial of the 2-week ITP (N = 10) had a 100% completion rate. A 1-week virtual CPT standalone option (N = 48) for civilians had a 96% completion rate. A small trial of the 1-week CPT option with veterans resulted in 90% and 100% completion rates for in-person (N = 21) and virtual options (N = 7), respectively. Findings support that intensive delivery of CPT is related with high rates of treatment completion, regardless of program length (1-week vs. 2-week vs. 3-week), delivery format, (in-person vs. virtual), adjunctive services (offered vs. not offered), and population (veteran vs. non-veteran).

The presentation will include providers’ perception of why these diverse intensive treatments resulted in high completion rates, such as the increased likelihood of staying in treatment after seeing results within the first few days of treatment, fewer opportunities for avoidance, and reduced logistical barriers.