Sticking it out in trauma-focused treatment for PTSD: It takes a village

Laura A. Meis, Siamak Noorbaloochi, Emily M. Hagel Campbell, Christopher R. Erbes, Melissa A. Polusny, Tina L. Velasquez, Ann Bangerter, Andrea Cutting, Afsoon Eftekhari, Craig S. Rosen, Peter W. Tuerk, Lori B. Burmeister, Michele R. Spoont

Research output: Contribution to journalArticle

8 Scopus citations


Objective: One in 3 veterans will dropout from trauma-focused treatments for posttraumatic stress disorder (PTSD). Social environments may be particularly important to influencing treatment retention. We examined the role of 2 support system factors in predicting treatment dropout: social control (direct efforts by loved ones to encourage veterans to participate in treatment and face distress) and symptom accommodation (changes in loved ones' behavior to reduce veterans' PTSD-related distress). Method: Veterans and a loved one were surveyed across 4 VA hospitals. All veterans were initiating prolonged exposure therapy or cognitive processing therapy (n = 272 dyads). Dropout was coded through review of VA hospital records. Results: Regression analyses controlled for traditional, individual-focused factors likely to influence treatment dropout. We found that, even after accounting for these factors, veterans who reported their loved ones encouraged them to face distress were twice as likely to remain in PTSD treatment than veterans who denied such encouragement. Conclusions: Clinicians initiating trauma-focused treatments with veterans should routinely assess how open veterans' support systems are to encouraging veterans to face their distress. Outreach to support networks is warranted to ensure loved ones back the underlying philosophy of trauma-focused treatments.

Original languageEnglish (US)
Pages (from-to)246-256
Number of pages11
JournalJournal of Consulting and Clinical Psychology
Issue number3
StatePublished - Mar 2019



  • accommodation
  • dropout
  • evidenced-based treatments
  • PTSD
  • social control

PubMed: MeSH publication types

  • Journal Article

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