Trauma-focused psychotherapies, such as prolonged exposure (PE), are strongly recommended to treat posttraumatic stress disorder due to their effects in reducing symptoms. However, such therapies may also suffer from high dropout rates. To investigate how clients might benefit from trauma-focused therapy while minimizing dropout, we conducted a meta-analysis of 1,508 adults from 35 randomized controlled trials (RCTs) of outpatient PE programs to evaluate treatment frequency as a predictor of dropout. When an RCT prescribed PE sessions at least twice weekly compared to less frequently, the dropout rate was significantly lower at 21.0%, 95% CI [13.9%, 30.4%], compared to 34.0%, 95% CI [28.9%, 39.4%], OR = 0.52, 95% CI [0.30, 0.89], p = .018. It was not possible to draw causal conclusions, as only one RCT compared two PE treatment frequencies head-to-head. Nonetheless, the findings remained significant after controlling for study characteristics. These data invite reconsideration of the common practice of weekly psychotherapy in favor of twice-weekly sessions in standard outpatient treatment.

中文翻译：

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每周至少两次的长期暴露治疗中的脱落率较低：随机对照试验的荟萃分析和系统评价

强烈建议以创伤为重点的心理治疗，例如长期暴露（PE），因为它们可以减轻症状，从而治疗创伤后应激障碍。然而，此类疗法也可能面临高退出率。为了调查客户如何从以创伤为中心的治疗中受益，同时最大限度地减少辍学，我们对门诊体育项目的 35 项随机对照试验 (RCT) 中的 1,508 名成年人进行了荟萃分析，以评估治疗频率作为辍学的预测因素。当随机对照试验规定每周至少两次体育锻炼时，与频率较低相比，脱落率显着降低，为 21.0%, 95% CI [13.9%, 30.4%]，而 34.0%, 95% CI [28.9%, 39.4%] ]，OR  = 0.52，95% CI [0.30，0.89]，p  = 0.018。不可能得出因果结论，因为只有一项随机对照试验对两种 PE 治疗频率进行了面对面的比较。尽管如此，在控制研究特征后，研究结果仍然很重要。这些数据促使人们重新考虑每周心理治疗的常见做法，转而支持标准门诊治疗中每周两次的治疗。