Evidence-Based Adjustments to Cognitive Processing Therapy to Reduce Dropout

Cognitive Processing Therapy (CPT) is an evidence-based, trauma-focused treatment for Posttraumatic Stress Disorder (PTSD). CPT is documented in an array of healthcare and diverse clinical settings for its effectiveness upon completion. For patients treated with CPT, dropout rates can range from 20-50% (depending on research laboratory and clinical setting data). Dropout typically occurs by session five, which research has noted is before progress is often observed with CPT. This early dropout can have the unintended effect of making patients think that CPT is not working for their PTSD symptoms, when in reality it is too early in treatment for effects to be observed. This article focuses on tailoring the first few sessions of CPT by strengthening early skills, improving patients’ understanding of therapy rationale, and increasing patients’ buy-in to help more patients reach session six and beyond.