Treatment Initiation and Dropout From Prolonged Exposure and Cognitive Processing Therapy in a VA Outpatient Clinic
Treatment Initiation and Dropout From Prolonged Exposure and Cognitive Processing Therapy in a VA Outpatient Clinic
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DOI：
10.1037/tra0000065
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发表时间：
2016-01-01
影响因子：
6.3
通讯作者：
Polusny, Melissa A.
中科院分区：
文献类型：
--
作者：
Kehle-Forbes, Shannon M.;Meis, Laura A.;Polusny, Melissa A.
新出现的数据表明，很少有退伍军人开始长期暴露（PE）和认知加工治疗（CPT），并且在那些开始治疗的人中辍学率很高。本研究的目的是使用常规临床护理中观察到的退伍军人的大样本，以1）报告合格和转诊退伍军人的百分比，这些退伍军人（a）开始PE/CPT，（B）退出PE/CPT，（c）早期PE/CPT退出，2）检查PE/CPT开始的预测因素，3）检查早期和晚期PE/CPT退出的预测因素。我们从427名退伍军人的医疗记录中提取数据，这些退伍军人在退伍军人健康管理局（VHA）PTSD临床小组接受PE/CPT治疗后接受治疗。82%（n = 351）的退伍军人通过参加PE/CPT第1次会议开始治疗;在这些退伍军人中，38.5%（n = 135）退出治疗。大约四分之一的退伍军人谁辍学被归类为早期辍学（辍学前第三届会议）。未发现显著的启动预测因素。年龄是治疗退出的一个重要预测因素;年轻的退伍军人比年长的退伍军人更有可能退出治疗。治疗类型也是一个显着的预测辍学;退伍军人接受PE更有可能退出晚于退伍军人接受CPT。研究结果表明，从PE/CPT辍学是一个严重的问题，并强调需要额外的研究，可以指导干预措施的发展，以提高PE/CPT的参与和遵守。
Emerging data suggest that few veterans are initiating prolonged exposure (PE) and cognitive processing therapy (CPT) and dropout levels are high among those who do start the therapies. The goal of this study was to use a large sample of veterans seen in routine clinical care to 1) report the percent of eligible and referred veterans who (a) initiated PE/CPT, (b) dropped out of PE/CPT, (c) were early PE/CPT dropouts, 2) examine predictors of PE/CPT initiation, and 3) examine predictors of early and late PE/CPT dropout. We extracted data from the medical records of 427 veterans who were offered PE/CPT following an intake at a Veterans Health Administration (VHA) PTSD Clinical Team. Eighty-two percent (n = 351) of veterans initiated treatment by attending Session 1 of PE/CPT; among those veterans, 38.5% (n = 135) dropped out of treatment. About one quarter of veterans who dropped out were categorized as early dropouts (dropout before Session 3). No significant predictors of initiation were identified. Age was a significant predictor of treatment dropout; younger veterans were more likely to drop out of treatment than older veterans. Therapy type was also a significant predictor of dropout; veterans receiving PE were more likely to drop out late than veterans receiving CPT. Findings demonstrate that dropout from PE/CPT is a serious problem and highlight the need for additional research that can guide the development of interventions to improve PE/CPT engagement and adherence.