Treatment-Related Beliefs and Reactions Among Trauma-Focused Therapy Completers and Discontinuers: A Qualitative Examination

Prolonged exposure (PE) and cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD) are effective, but some patients do not respond adequately, and dropout rates are high. Patients' beliefs about treatment and perceptions of treatment components influence treatment outcomes...

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Veröffentlicht in:Psychological services 2024-11, Vol.21 (4), p.859-870
Hauptverfasser: Alpert, Elizabeth, Gowdy-Jaehnig, Alexandra, Galovski, Tara E., Meis, Laura A., Polusny, Melissa A., Ackland, Princess E., Spoont, Michele, Valenstein-Mah, Helen, Orazem, Robert J., Schnurr, Paula P., Chard, Kathleen M., Kehle-Forbes, Shannon M.
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container_end_page 870
container_issue 4
container_start_page 859
container_title Psychological services
container_volume 21
creator Alpert, Elizabeth
Gowdy-Jaehnig, Alexandra
Galovski, Tara E.
Meis, Laura A.
Polusny, Melissa A.
Ackland, Princess E.
Spoont, Michele
Valenstein-Mah, Helen
Orazem, Robert J.
Schnurr, Paula P.
Chard, Kathleen M.
Kehle-Forbes, Shannon M.
description Prolonged exposure (PE) and cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD) are effective, but some patients do not respond adequately, and dropout rates are high. Patients' beliefs about treatment and perceptions of treatment components influence treatment outcomes and may be amenable to change through intervention. The present study sought to identify beliefs and reactions to PE and CPT that differentiated completers who screened negative for a PTSD diagnosis after treatment (PTSD−), completers who screened positive for a PTSD diagnosis after treatment (PTSD+), and discontinuers who attended six or fewer sessions. Thematic analysis was used to identify themes in qualitative data collected via retrospective semistructured interviews with 51 completers (19 PTSD− after treatment, 32 PTSD+ after treatment) and 66 discontinuers of PE/CPT. Participants were demographically diverse veterans across service eras. Treatment-related beliefs and reactions differentiating these groups included perceived helpfulness of treatment, self-efficacy in engaging in treatment, anticipatory anxiety and concerns, interpretations of ongoing symptoms, and perceived consequences of treatment on functioning. Further, some patterns seemed to differ in early treatment sessions compared to during the active components of treatment. Findings point to potentially malleable targets that could be intervened upon to improve trauma-focused treatment outcomes. Impact Statement Evidence-based PTSD treatments are available, but a significant number of patients do not experience meaningful symptom reduction, and a significant number do not complete treatment. This study identified treatment-related beliefs and reactions differentiating participants who discontinued treatment early and who completed treatment and screened positive versus negative for a PTSD diagnosis after treatment. Findings point to processes that could be targeted to improve PTSD treatment completion rates and symptom outcomes.
doi_str_mv 10.1037/ser0000831
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subjects Adult
Attitudes
Cognitive Behavioral Therapy
Female
Health Knowledge, Attitudes, Practice
Human
Humans
Implosive Therapy
Male
Middle Aged
Military Veterans
Patient Dropouts
Posttraumatic Stress Disorder
Qualitative Research
Retrospective Studies
Stress Disorders, Post-Traumatic - therapy
Trauma-Focused Cognitive Behavior Therapy
Treatment Outcomes
Veterans - psychology
title Treatment-Related Beliefs and Reactions Among Trauma-Focused Therapy Completers and Discontinuers: A Qualitative Examination
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