Category: PTSD

Symposium

Predictors of Treatment Engagement in Cognitive Processing Therapy for PTSD Among Active Military

Sunday, November 19
8:30 AM - 10:00 AM
Location: Sapphire Ballroom M & N, Level 4, Sapphire Level

Keywords: CPT (Cognitive Processing Therapy) | Military | PTSD
Presentation Type: Symposium

Cognitive processing therapy (CPT) is an effective treatment for posttraumatic stress disorder (PTSD), but its effectiveness may be limited if patients fail to engage with the treatment or terminate prematurely. Age has been shown to be a significant predictor of treatment dropout in several studies of veterans (e.g., Kehle-Forbes et al., 2016). Other factors shown to predict dropout include higher levels of PTSD and depressive symptomatology, although other studies fail to find an association with these factors. Active military also have unique factors (e.g. duty obligations) that may impact their ability to engage in and complete treatment (Wachen, et al., 2016). No studies to date have compared characteristics of treatment completers and early terminators in an active military sample. Participants were 268 active duty servicemembers who received either group or individual CPT as part of a randomized clinical trial through the STRONG STAR Consortium. Demographic variables (including age, gender, race, rank, years of service, education, history of head injuries), baseline symptom levels (PTSD and depression), and treatment expectancy were examined with respect to number of sessions attended and treatment termination/completion status. Homework compliance was also examined as an indicator of treatment engagement. Over one-quarter of the sample (26%) did not complete treatment (attended 9 sessions or more) due to military factors.  Older age, higher military rank, and lower levels of depressive symptoms at baseline were related to completion of treatment. How often participants completed homework and number of minutes spent on practice assignments were also predictive of treatment completion.  Other factors including baseline PTSD symptoms, number of deployments, years since index event, history of head injury, and credibility beliefs about the treatment did not predict treatment completion.  These findings are an important first step in understanding which active duty service members are likely to successfully complete a course of CPT. Clinical implications for identifying patients more likely to prematurely discontinue treatment will be discussed.

Jennifer S. Wachen

National Center for PTSD, VA Boston Healthcare System; Boston University School of Medicine

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