PTSD Treatment For Active-Duty Military: The Dropout Problem
PTSD affects 11 to 20% of veterans, which makes early intervention critical. Rather than wait until they’re discharged, many treatment centers promote care while military service members are still on active duty. But dropout rates from PTSD therapy programs for active-duty participants are high. A new study sought to find out why.
The study, published in the journal Behaviour Research and Therapy, was led by Hunter College Professor Danielle Berke. Berke and researchers from several leading institutions, including the National Center for PTSD, Stanford University School of Medicine, and the University of Texas, looked at active-duty service members in treatment at the Carl R. Darnall Army Medical Center in Fort Hood, Texas. Over three trials, they found that service members on average didn’t attend all of their sessions, and 30.7% dropped out. Demographically, those with lower participation rates tended to be younger, which the researchers concluded was because they “have more competing life responsibilities, demands, or needs” compared with older service members.
They also found that attendance was lower among those who didn’t find the treatment helpful. “Patients who perceived treatment to be logical attended more sessions,” they wrote. The majority who skipped their final session had “either experienced no clinically significant improvement or declined.”
The study also found that the type of treatment mattered. Present-centered therapy, which focuses on “current-life concerns and patient-directed problem-solving,” resulted in lower dropout rates than trauma-focused treatments, which “ask the patient to directly confront thoughts or memories of traumatic events.” Because trauma-focused treatment can be “especially challenging for patients to tolerate,” the authors suggest that present-centered therapy “should be considered as a treatment option for service-members with PTSD, particularly those who are at risk of dropout.”