Faculty Collaboration Database

Symptom change prior to treatment discontinuation (dropout) from a naturalistic Veterans Affairs evidence-based psychotherapy clinic for PTSD and depression. Psychol Serv 2023 Nov;20(4):831-838

Date

03/24/2023

Pubmed ID

36951729

DOI

10.1037/ser0000757

Scopus ID

2-s2.0-85158150637 (requires institutional sign-in at Scopus site)   2 Citations

Abstract

Dropout or treatment discontinuation from evidence-based psychotherapies (EBPs) has been a concern for clinicians as it is thought that such discontinuation prevents patients from achieving a full course of therapy and obtaining maximum benefit. Recent studies, however, suggest that treatment discontinuation may sometimes be due to symptom improvement. The purpose of the current evaluation was to examine change in self-reported symptoms in participants who completed versus did not complete treatment in a Veterans Affairs outpatient clinic offering EBPs for both depression and posttraumatic stress disorder (PTSD). Data were collected from 128 participants who had at least one treatment session postintake and had been discharged from the clinic. Data were collected on self-reported PTSD and depression symptoms. Of the 128 veterans, 61 completed treatment and 67 did not complete treatment (54.0% noncompletion in PTSD EBPs and 48.7% noncompletion in depression EBPs). Of those who did not complete, 47 were enrolled in a PTSD EBP and 20 in a depression EBP. Of those who did not complete a PTSD EBP, 51.1% had no change in PTSD symptoms prior to treatment discontinuation, whereas 12.8% had a symptom increase, and 27.7% had a symptom decrease. Of those who did not complete a depression EBP, 55% had no change in depression symptoms prior to treatment discontinuation, 15% had a symptom increase, and 30% had a decrease. Overall, results suggest that treatment discontinuation is not as straightforward as it may seem and that prematurely discontinuing an EBP may not necessarily represent treatment failure. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Author List

Larsen SE, Hamrick LA, Thomas KB, Hessinger JD, Melka SE, Khaled M, Hove MC, Maieritsch K

Authors

Mary Christina Hove MD Assistant Professor in the Psychiatry and Behavioral Medicine department at Medical College of Wisconsin
Sadie E. Larsen PhD Associate Professor in the Psychiatry and Behavioral Medicine department at Medical College of Wisconsin
Stephen E. Melka PhD Assistant Professor in the Psychiatry and Behavioral Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Ambulatory Care Facilities
Depression
Humans
Psychotherapy
Stress Disorders, Post-Traumatic
Symptom Flare Up
United States
United States Department of Veterans Affairs
Veterans