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在一家为人际暴力受害者服务的社区心理健康诊所中,基于证据的创伤治疗的脱落率。

Dropout from evidence-based trauma treatment in a community mental health clinic serving victims of interpersonal violence.

机构信息

Department of Advanced Studies in Education and Counseling, California State University Long Beach, Long Beach, California, USA.

Psychology Research Center, School of Psychology, University of Minho, Braga, Portugal.

出版信息

J Trauma Stress. 2022 Jun;35(3):1025-1041. doi: 10.1002/jts.22811. Epub 2022 Feb 28.

Abstract

Trauma-focused psychotherapies are increasingly offered in community-based mental health centers, but little is known about treatment dropout in these settings. The current study explored dropout at different stages of treatment in a treatment-seeking sample of 1,186 adults who experienced interpersonal violence and were offered trauma-focused and non-trauma-focused therapies. A total of 31.6% of participants dropped out before treatment initiation, 28.0% dropped out after treatment initiation and completed a mean of 4.02 (SD = 2.41) sessions, and 40.4% completed a full course of PTSD treatment. Being unemployed, p < .001, and scoring lower on measures of environment factors, p = .045, were significant predictors of pretreatment dropout. Being female, p < .001; Latinx, p = .032; and scoring higher on a measure of social relationships, p = .024, were independent predictors of postinitiation dropout. Individuals who completed nine sessions of treatment displayed significantly lower levels of posttraumatic stress disorder, depression, and anxiety symptoms. The present study provides preliminary evidence that survivors of interpersonal violence who seek therapy tend to drop out early during treatment, and most who complete treatment attain symptom reduction.

摘要

创伤为中心的心理治疗越来越多地在社区为基础的心理健康中心提供,但在这些环境中,关于治疗脱落的了解甚少。本研究探讨了在寻求治疗的 1186 名经历人际暴力并接受创伤为中心和非创伤为中心治疗的成年人样本中治疗不同阶段的脱落情况。共有 31.6%的参与者在治疗开始前脱落,28.0%在治疗开始后脱落并完成了 4.02 次(SD=2.41)的平均治疗,40.4%完成了 PTSD 治疗的全过程。失业(p<.001)和环境因素测量得分较低(p=.045)是治疗前脱落的显著预测因素。女性(p<.001);拉丁裔(p=.032)和社会关系测量得分较高(p=.024)是治疗开始后脱落的独立预测因素。完成九次治疗的个体表现出明显较低水平的创伤后应激障碍、抑郁和焦虑症状。本研究提供了初步证据,表明寻求治疗的人际暴力幸存者在治疗早期倾向于提前脱落,大多数完成治疗的人会减轻症状。

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