Symposia
Trauma and Stressor Related Disorders and Disasters
Kelly Harper, Ph.D.
Postdoctoral fellow
National Center for PTSD
Boston, Massachusetts
Daniel Lee, PhD
Staff Investigator
National Center for PTSD
Boston, Massachusetts
Samantha Mosier, PhD
Assistant Professor
Emmanuel College
Boston, Massachusetts
Ilana Zweig, BS
Research Assistant
National Center for PTSD
Boston, Massachusetts
terence keane, ph.d.
professor
VA Boston Healthcare System
boston, MA
Brian Marx, PhD
Deputy Director
National Center for PTSD
Boston, Massachusetts
Past research on mental health treatment utilization among individuals with posttraumatic stress disorder (PTSD) often defines an “adequate dose” of individual and group psychotherapy as receiving at least 9 sessions within a 15-week period. However, few studies have examined whether this dose of treatment is associated with significant change in PTSD symptoms. To examine whether an “adequate dose” of psychotherapy was associated with PTSD symptom improvement we examined patient electronic medical records on mental health outpatient visits among a cohort of OEF/OIF veterans enrolled in Veterans Health Administration (VHA) services (N =1,649) across 5 years. Using latent growth curve modeling, we estimated the effect of receiving an adequate dose of individual psychotherapy on PTSD symptom course. Among the full sample, 992 participants (60.16%) received at least one individual therapy sessions; of those with at least one individual therapy visit, 226 (22.78%) received an adequate dose of individual therapy. Female veterans were significantly more likely than male veterans to receive an adequate dose of individual psychotherapy. Although receiving an adequate treatment dose was associated with a decrease in PTSD Checklist for DSM-5 (PCL-5) scores over time, this improvement was extremely gradual (average of 1.57 PCL-5 point decrease per year), a magnitude well below established metrics for reliable symptom reduction. Although some covariates predicted PCL-5 score at treatment onset, no included covariates predicted the effect of adequate dose treatment on PTSD symptom change. Findings indicate a need for research on defining what an adequate dose of care is based on symptom change, and the importance of not only examining the quantity or frequency of care but also the quality of care received.