If No PTSD Symptom Improvement by Week 6, Veterans Likely to Quit CPT

Military veterans undergoing cognitive processing therapy with written trauma account (CPT-A) for post-traumatic stress disorder (PTSD) tend to quit therapy if they have not experienced any improvement by the end of the sixth session, according to a study published in the journal Behaviour Research and Therapy.

“When symptom amelioration is not observed by the midway point in CPT-A, a change in therapeutic approach appears warranted for preempting dropout among veterans and boosting treatment retention,” wrote researchers from the Cincinnati Veterans Affairs (VA) Medical Center.

CPT-A is a leading evidence-based psychotherapy for PTSD, researchers explained. Yet despite its efficacy, a lack of response and premature dropout are common among veterans. 

The study investigated the timing of symptom change and treatment dropout in 194 veterans receiving outpatient CPT-A at a VA specialty clinic.

Between 49% and 61% of veterans reporting meaningful symptom improvement with CPT-A, researchers reported. However, 40% of veterans quit treatment early.

“The cumulative probability of dropout exceeded the probability of symptom change beginning after session six of therapy,” researchers wrote. “Secondary analyses indicated that this six session rule generalized well across subgroups.”—Jolynn Tumolo