Exposure Utilization and Completion of Cognitive Behavioral Therapy for PTSD in a “RealWorld” Clinical Practice

Authors

Claudia Zayfert, Dartmouth Medical School, Lebanon, New Hampshire.
Jason C. DeViva, Dartmouth Medical School, Lebanon, New Hampshire
Carolyn Becker, Trinity University, San Antonio, Texas.
Julie L. Pike, Dartmouth Medical School, Lebanon, New Hampshire
Karen L. Gillock, Dartmouth Medical School, Lebanon, New Hampshire
Sarah A. Hayes, University of Nebraska-Lincoln

Date of this Version

December 2005

Comments

Published in Journal of Traumatic Stress, Vol. 18, No. 6, December 2005, pp. 637–645 (2005).

Abstract

This study assessed rates of imaginal exposure therapy (ET) utilization and completion of cognitive behavioral therapy (CBT) for posttraumatic stress disorder (PTSD) in a clinical setting and examined variables associated with CBT completion. Using a clinical definition, the completion rate of CBT was markedly lower than rates reported in randomized trials. CBT completion was inversely related to severity of overall pretreatment measures of PTSD, avoidance, hyperarousal, depression, impaired social functioning, and borderline personality disorder. Regression yielded avoidance and depression as unique predictors of completion. Most dropouts occurred before starting imaginal ET, although initiating ET was associated with greater likelihood of completion. Results highlight methodological differences between research and practice notions of treatment completion and the need for further study of variables influencing CBT completion in practice settings.