Intensive trauma-focused treatment for post traumatic stress disorder: a systematic review of dropout and a retrospective case series of clinical outcomes

Leonard, Eleanor 2026. Intensive trauma-focused treatment for post traumatic stress disorder: a systematic review of dropout and a retrospective case series of clinical outcomes. ClinPsy Thesis, Cardiff University. Item availability restricted.

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Abstract

Abstract Guideline-recommended treatments for post-traumatic stress disorder (PTSD) are well established and empirically supported. However, treatment dropout remains a challenge, with predictors of dropout showing inconsistent findings. Emerging evidence suggests that the spacing of therapy sessions may influence dropout. In response, condensed PTSD treatments delivered over shorter timeframes, termed intensive trauma-focused treatment programmes (ITTPs), have been developed with reduced dropout rates increasingly observed. The aim of this systematic review and meta-analysis was to examine the pooled dropout rate among civilian populations receiving an ITTP and to explore factors associated with dropout. A protocol was preregistered on PROSPERO, and searches were run across four electronic databases. Using a predefined eligibility criterion, 20 studies were included, comprising 2,537 participants. Study quality was assessed using the Joanna Briggs Institute tools. A random-effects meta-analysis reported a pooled dropout rate of 4.62% (95% CI 2.34 – 7.51), although heterogeneity was high (I² = 87%). Subgroup analyses indicated lower dropout in studies that had higher session frequencies and in residential settings. Narrative synthesis suggested that the definition of dropout may have contributed to variability, and no clear influences were observed for clinical characteristics. The interpretation of other factors was limited by inconsistent reporting or limited variability. With respect to dropout, the findings suggest that ITTPs may be an acceptable treatment option for PTSD, with relatively low dropout rates compared to weekly delivery. Greater methodological consistency in reporting dropout is needed to clarify predictors and to strengthen future evidence synthesis. This would help inform clinical decision-making and service planning.

Item Type:	Thesis (DClinPsy)
Date Type:	Completion
Status:	Unpublished
Schools:	Schools > Psychology
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Uncontrolled Keywords:	Post-Traumatic Stress Disorder; Dropout; Intensive Treatment; Trauma-Focused; Civilians; Meta-analysis; Systematic Review
Date of First Compliant Deposit:	28 September 2026
Last Modified:	28 Sep 2026 09:24
URI:	https://orca.cardiff.ac.uk/id/eprint/189662

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