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Less dropout from prolonged exposure sessions prescribed at least twice weekly: A meta-analysis and systematic review of randomized controlled trials.

Publication ,  Journal Article
Levinson, DB; Halverson, TF; Wilson, SM; Fu, R
Published in: J Trauma Stress
August 2022

Trauma-focused psychotherapies, such as prolonged exposure (PE), are strongly recommended to treat posttraumatic stress disorder due to their effects in reducing symptoms. However, such therapies may also suffer from high dropout rates. To investigate how clients might benefit from trauma-focused therapy while minimizing dropout, we conducted a meta-analysis of 1,508 adults from 35 randomized controlled trials (RCTs) of outpatient PE programs to evaluate treatment frequency as a predictor of dropout. When an RCT prescribed PE sessions at least twice weekly compared to less frequently, the dropout rate was significantly lower at 21.0%, 95% CI [13.9%, 30.4%], compared to 34.0%, 95% CI [28.9%, 39.4%], OR = 0.52, 95% CI [0.30, 0.89], p = .018. It was not possible to draw causal conclusions, as only one RCT compared two PE treatment frequencies head-to-head. Nonetheless, the findings remained significant after controlling for study characteristics. These data invite reconsideration of the common practice of weekly psychotherapy in favor of twice-weekly sessions in standard outpatient treatment.

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Published In

J Trauma Stress

DOI

EISSN

1573-6598

Publication Date

August 2022

Volume

35

Issue

4

Start / End Page

1047 / 1059

Location

United States

Related Subject Headings

  • Waiting Lists
  • Treatment Outcome
  • Stress Disorders, Post-Traumatic
  • Randomized Controlled Trials as Topic
  • Psychotherapy
  • Psychiatry
  • Humans
  • Cognitive Behavioral Therapy
  • Adult
  • 5203 Clinical and health psychology
 

Citation

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Levinson, D. B., Halverson, T. F., Wilson, S. M., & Fu, R. (2022). Less dropout from prolonged exposure sessions prescribed at least twice weekly: A meta-analysis and systematic review of randomized controlled trials. J Trauma Stress, 35(4), 1047–1059. https://doi.org/10.1002/jts.22822
Levinson, Daniel B., Tate F. Halverson, Sarah M. Wilson, and Rongwei Fu. “Less dropout from prolonged exposure sessions prescribed at least twice weekly: A meta-analysis and systematic review of randomized controlled trials.J Trauma Stress 35, no. 4 (August 2022): 1047–59. https://doi.org/10.1002/jts.22822.
Levinson, Daniel B., et al. “Less dropout from prolonged exposure sessions prescribed at least twice weekly: A meta-analysis and systematic review of randomized controlled trials.J Trauma Stress, vol. 35, no. 4, Aug. 2022, pp. 1047–59. Pubmed, doi:10.1002/jts.22822.
Journal cover image

Published In

J Trauma Stress

DOI

EISSN

1573-6598

Publication Date

August 2022

Volume

35

Issue

4

Start / End Page

1047 / 1059

Location

United States

Related Subject Headings

  • Waiting Lists
  • Treatment Outcome
  • Stress Disorders, Post-Traumatic
  • Randomized Controlled Trials as Topic
  • Psychotherapy
  • Psychiatry
  • Humans
  • Cognitive Behavioral Therapy
  • Adult
  • 5203 Clinical and health psychology