Category: Trauma and Stressor Related Disorders and Disasters
Jenna Bagley, B.S., B.A.
Case Western Reserve University
Cleveland, Ohio
Tara Galovski, Ph.D.
VA National Center for PTSD, Boston University School of Medicine
Boston, Massachusetts
Kelly Harper, Ph.D.
Postdoctoral fellow
National Center for PTSD
Boston, Massachusetts
Jenna Bagley, B.S., B.A.
Case Western Reserve University
Cleveland, Ohio
Skye Fitzpatrick, Ph.D.
Professor
York University
Toronto, Ontario, Canada
Cynthia Yamokoski, Ph.D.
PTSD Mentoring Program, Associate Director
National Center for PTSD
Kent, Ohio
Identifying the “optimal dose” of psychotherapy for improvement or recovery is important for establishing efficient and effective delivery of treatment. A sound understanding of dose-response patterns for therapeutic interventions can be used to support treatment planning and routine outcome monitoring, as well as to inform policy decisions. Posttraumatic stress disorder (PTSD) researchers have begun to examine the degree to which psychotherapy dose is associated with treatment outcomes, with a particular focus on the number of visits or frequency of sessions. Some research with veterans has suggested 8 sessions to be as “adequate” dose of evidence-based psychotherapy (e.g., Hale et al., 2019; Mott et al., 2014; Spoont et al., 2010). However, the number and/or frequency of sessions needed to maximize improvement, and the ways this may differ by patients and across treatment modalities, requires further investigation. In this symposium, we will present research findings on therapy dose factors among veterans and non-veterans with PTSD and how these different dose factors relate to clinical outcomes across differing PTSD treatments. First, Kelly Harper will report findings from a study on whether the receipt of an “adequate dose” of psychotherapy is related to longitudinal clinical outcomes using medical record data to determine dose of psychotherapy. Next, Jenna Bagley will present data from a study examining whether “adequate dose” varies across three treatment conditions—Prolonged Exposure (PE) only, sertraline only, and combined PE and sertraline—and the impact of additional visits on clinical outcomes. Skye Fitzpatrick will then report on the use of propensity scores to isolate the effect of treatment dose on PTSD and alcohol/other drug disorder outcomes across treatments. Lastly, Cynthia Yamokoski will present results from a study examining the impact of session frequency by comparing treatment outcomes of PE or Cognitive Processing Therapy (CPT) provided in either a weekly, three times per week, or five times per week format. Overall, these papers highlight the importance of psychotherapy dose for treating PTSD. Additionally, this symposium addresses the complexity of identifying an “optimal dose” of psychotherapy for PTSD and the necessity of examining outcomes across the spectrum of study designs, from clinical trials and program evaluation to review of administrative and clinical records. Importantly, a diversity of treatment types and populations are included, with the express goal of helping clinicians examine the various factors that contribute to dose-response patterns across individuals receiving different therapeutic modalities.