Dropout From Psychological Therapies for Post-Traumatic Stress Disorder (PTSD) in Adults: Systematic Review and Meta-Analysis

Course overview

This course is based upon material published in the European Journal of Psychotraumatology and is available as an open access article. Background Despite the established efficacy of psychological therapies for post-traumatic stress disorder (PTSD) there has been little systematic exploration of dropout rates. Objective To ascertain rates of dropout across different modalities of psychological therapy for PTSD and to explore potential sources of heterogeneity. Method A systematic review of dropout rates from randomized controlled trials (RCTs) of psychological therapies was conducted. The pooled rate of dropout from psychological therapies was estimated and reasons for heterogeneity explored using metaregression. Results: The pooled rate of dropout from RCTs of psychological therapies for PTSD was 16% (95% CI 14 18%). There was evidence of substantial heterogeneity across studies. We found evidence that psychological therapies with a trauma-focus were significantly associated with greater dropout. There was no evidence of greater dropout from therapies delivered in a group format; from studies that recruited participants from clinical services rather than via advertisements; that included only military personnel/veterans; that were limited to participants traumatized by sexual traumas; that included a higher proportion of female participants; or from studies with a lower proportion of participants who were university educated. Conclusions: Dropout rates from recommended psychological therapies for PTSD are high and this appears to be particularly true of interventions with a trauma focus. There is a need to further explore the reasons for dropout and to look at ways of increasing treatment retention. This course on dropout from PTSD therapy is designed for social workers, professional counselors, psychologists, nurses, and substance abuse counselors, who do clinical work. This course is appropriate for beginning, intermediate and advanced level practitioners who wish to develop or increase their knowledge PTSD therapy dropout. The course material includes a literature review of research studies related to PTSD therapy. It may also be useful for licensed clinicians who require clinical continuing education courses for license renewal. The course is based on a journal article which includes research. It contains statistical analysis and data that some clinicians enjoy reading and others do not. A major benefit of reading research-based articles for continuing education is they provide practitioners with the latest findings in their field. Authors: Catrin Lewis, Neil P. Roberts, Samuel Gibson, and Jonathan I. Bisson Learning Objectives: This course will provide the practitioner with detailed information regarding dropout from PTSD therapy. Specifically, a professional will: Describe the rate of dropout across different modalities of psychological therapy for PTSD Identify potential sources of heterogeneity across study participants Explain which interventions for PTSD are particularly prone to dropout Citation: Lewis, Catrin, et al. Dropout From Psychological Therapies for Post-Traumatic Stress Disorder (PTSD) in Adults: Systematic Review and Meta-Analysis. European Journal of Psychotraumatology 2020, Vol 11, 1709709. https://doi.org/10.1080/20008198.2019.1709709