A meta-analysis of dropout from evidence-based psychological treatment for post-traumatic stress disorder (PTSD) in children and young people. Issue 1 (1st January 2021)

• Record Type: Journal Article
• Authors: Simmons, Caroline; Meiser-Stedman, Richard; Baily, Hannah; Beazley, Peter
• Is Part Of: European journal of psychotraumatology. Volume 12:Issue 1(2021)
• Publication Date: 2021-01-01
• Subjects: PTSD -- dropout -- psychotherapy -- CBT -- EMDR -- acceptability -- TF-CBT -- children -- adolescents; TEPT -- abandono -- psicoterapia -- CBT -- EMDR -- aceptabilidad -- TF-CBT -- niños -- adolescentes; PTSD -- 退出 -- 心理治疗 -- CBT -- EMDR -- 可接受性 -- TF-CBT -- 孩子 -- 年轻人; Post-traumatic stress disorder -- Periodicals; Stress Disorders, Post-Traumatic; Post-traumatic stress disorder; Electronic journals; Periodicals; Periodicals; Fulltext; Internet Resources; Periodicals; 616.8521
• DOI: 10.1080/20008198.2021.1947570
• Languages: English
• ISSNs: 2000-8198

Abstract

ABSTRACT: Background: Despite the established evidence base of psychological interventions in treating PTSD in children and young people, concern that these trauma-focused treatments may 'retraumatise' patients or exacerbate symptoms and cause dropout has been identified as a barrier to their implementation. Dropout from treatment is indicative of its relative acceptability in this population. Objective: Estimate the prevalence of dropout in children and young people receiving a psychological therapy for PTSD as part of a randomized controlled trial (RCT). Methods: A systematic search of the literature was conducted to identify RCTs of evidence-based treatment of PTSD in children and young people. Proportion meta-analyses estimated the prevalence of dropout. Odds ratios compared the relative likelihood of dropout between different treatments and controls. Subgroup analysis assessed the impact of potential moderating variables. Results: Forty RCTs were identified. Dropout from all treatment or active control arms was estimated to be 11.7%, 95% CI [9.0, 14.6]. Dropout from evidence-based treatment (TFCBTs and EMDR) was 11.2%, 95% CI [8.2, 14.6]. Dropout from non-trauma focused treatments or controls was 12.8%, 95% CI [7.6, 19.1]. There was no significant difference in the odds of dropout when comparing different modalities. Group rather than individual delivery, and lay versus professional delivery, were associated with less dropout. Conclusions: Evidence-based treatments for children and young people with PTSD do not result in higher prevalence of dropout than non-trauma focused treatment or waiting list conditions. Trauma-focused therapies appear to be well tolerated in children and young people. HIGHLIGHTS: Dropout from RCTs is not more likely for trauma-focused treatments than for non-trauma-focused arms or control conditions. Trauma-focused treatments for PTSD are acceptable to most youth.