Comparing the Predictors of Disengagement for Trauma Therapy (TF-CBT and EMDR) in an Adult Mental Health Service

Abstract

In this retrospective service evaluation, the predictors of disengagement from trauma therapy are investigated, as previous research suggests that disengagement rates may be higher than other therapies. Clients on the posttraumatic stress disorder treatment pathway received either eye movement desensitization and reprocessing (EMDR) or trauma-focused cognitive behavioral therapy (TF-CBT). Preexisting data from 105 cases at a National Health Service Adult Community Mental Health Team were collected, and disengagement rates were compared based on demographic therapy and Health of the Nation Outcome Scales scores to investigate the impact they have on disengagement rates. Results found a different proportion of those receiving EMDR disengaged (62.8%) than those who received TF-CBT (55.3%), though this difference was nonsignificant. There was a significant association between disengagement rates and depressed mood (77.8% in moderate to severe group vs 51.2% in no to mild group). There was also a significant association between disengagement rates and living conditions (84.0% in minor to severe group vs 53.7% in no problem group). No significant associations were found between disengagement and demographic variables (age, gender, and ethnicity) or time spent waiting for intervention. The implications of these findings and practice recommendations are discussed.