A meta-analysis of dropout from evidence-based psychological treatment for post-traumatic stress disorder (PTSD) in children and young people

Caroline Simmons, Richard Meiser-Stedman, Hannah Baily, Peter Beazley

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Background: Despite the established evidence base of psychological interventions in treating PTSD in children and young people, concern that these trauma-focused treatments may ‘retraumatise’ patients or exacerbate symptoms and cause dropout has been identified as a barrier to their implementation. Dropout from treatment is indicative of its relative acceptability in this population. Objective: Estimate the prevalence of dropout in children and young people receiving a psychological therapy for PTSD as part of a randomized controlled trial (RCT). Methods: A systematic search of the literature was conducted to identify RCTs of evidence-based treatment of PTSD in children and young people. Proportion meta-analyses estimated the prevalence of dropout. Odds ratios compared the relative likelihood of dropout between different treatments and controls. Subgroup analysis assessed the impact of potential moderating variables. Results: Forty RCTs were identified. Dropout from all treatment or active control arms was estimated to be 11.7%, 95% CI [9.0, 14.6]. Dropout from evidence-based treatment (TFCBTs and EMDR) was 11.2%, 95% CI [8.2, 14.6]. Dropout from non-trauma focused treatments or controls was 12.8%, 95% CI [7.6, 19.1]. There was no significant difference in the odds of dropout when comparing different modalities. Group rather than individual delivery, and lay versus professional delivery, were associated with less dropout. Conclusions: Evidence-based treatments for children and young people with PTSD do not result in higher prevalence of dropout than non-trauma focused treatment or waiting list conditions. Trauma-focused therapies appear to be well tolerated in children and young people.

Original languageEnglish
Article number1947570
JournalEuropean Journal of Psychotraumatology
Issue number1
Publication statusPublished - 5 Aug 2021


  • CBT
  • EMDR
  • PTSD
  • TF-CBT
  • acceptability
  • adolescents
  • children
  • dropout
  • psychotherapy

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