(PS5-A11) Cognitive Processing Therapy Treatment Outcome in Community Clinic

There currently exist multiple efficacious, evidence-based treatments for PTSD. However, the rate of dropout and attrition remain significant. Continued research devoted to understanding poor treatment outcomes, whether nonresponse or dropout, is essential to improve present treatments or initiate the development of new treatments. The present study sought to examine PTSD treatment outcome for clients receiving Cognitive Processing Therapy (CPT) within a specialized PTSD clinic.

Participants included 51 clients who attended at least one CPT treatment session. Clinicians were comprised of clinical psychology doctoral candidates supervised by a clinical psychologist with expertise in treating PTSD. Participants were considered treatment completers (n = 30, 58.8%) if they attended 8 or more sessions of CPT. Participants were considered responders (n = 30, 58.8%) if they had a 30% or greater reduction in PTSD symptoms. Variables examined included PTSD symptoms, depressive symptoms, and session attendance as well as demographics variables (age, gender, race/ethnicity, education, and relationship status).

Significant correlations were found between age and final PCL-5 (r = .38 p = .006) and BDI (r = .33, p = .025) scores. No other demographics were significantly related to treatment outcome. When treatment completion was examined, those who completed at least 8 sessions had significantly lower final PTSD (t(49) = -2.77, p = .008) and depression symptoms (t(45) = -3.02 p = .004) than those who attended fewer than 8 sessions. Specifically, those who completed had lower PCL-5 (M = 25.93, SD = 23.37) and BDI (M = 16.85, SD = 14.08) symptoms compared to those who did not complete (PCL-5 M = 44.52, SD = 23.83; BDI M = 30.09, SD = 15.88).

Examination of treatment responders indicated significant differences in final depressive symptoms (t(45) = -7.74 p < .001) and session attendance (t(49) = 4.00 p < .001). Those who had 30% or greater PTSD symptom reduction had lower final depressive symptoms (M = 11.65, SD = 8.92) than those who did not (M = 35.89, SD = 12.53). Further, treatment responders also attended more sessions (M = 11.33, SD = 4.48) than those who did not respond (M = 6.19 SD = 4.58).

Overall, our results show that approximately 3 in 5 clients had a significant reduction in their PTSD symptoms. These results suggest that PTSD treatment and PTSD symptom improvement are linked with improved depressive symptoms. Unsurprisingly, increased session attendance was also related to decreased PTSD symptom severity at the end of treatment. Older age, poor session attendance, and higher depressive symptoms at final session were related to poor treatment response. It is possible that age is a proxy for PTSD chronicity and thus, not necessarily a risk factor for poor treatment response.