Format

Send to

Choose Destination
Psychol Serv. 2018 Nov 26. doi: 10.1037/ser0000316. [Epub ahead of print]

"It didn't fit for me:" A qualitative examination of dropout from prolonged exposure and cognitive processing therapy in veterans.

Author information

1
VA HSR&D Houston Center of Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center.
2
Michael E. DeBakey VA Medical Center.

Abstract

Trauma-focused psychotherapies, such as prolonged exposure and cognitive processing therapy, are the most effective forms of treatment for posttraumatic stress disorder. These treatments are commonly delivered in the Veterans Health Administration; however, dropout means that some veterans fail to benefit. Ending treatment prematurely is a common problem across psychotherapies, with on average, 20% to 25% of patients dropping out. The purpose of this study was to examine veterans' self-reported reasons for dropping out of prolonged exposure or cognitive processing therapy. Veterans who dropped out from prolonged exposure or cognitive processing therapy (N = 28) completed qualitative interviews about their experiences. Interviews were coded by 2 coders using grounded theory. Therapy-related barriers were the largest category reported, and included lack of buy-in to the rationale or specific therapy tasks, believing that treatment was not working, alliance issues, or switching to a different treatment. Practical barriers and finding treatment "too stressful" were also common reasons for dropout. This research provides information that can shape how PTSD treatments are delivered in health care settings. Therapy-related barriers were the largest group, suggesting that providers may need to find more effective ways to communicate the rationale for these therapies or to tailor them to individual patients' needs. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

PMID:
30475041
PMCID:
PMC6535373
[Available on 2020-05-26]
DOI:
10.1037/ser0000316

Supplemental Content

Loading ...
Support Center