- Group-based trauma-focused therapy had significantly lower dropout rates than individual therapy, even after adjusting for covariates.
- Individual therapy was associated with more than double the dropout hazard compared with group formats (adjusted HR = 2.34, p = .010).
- Baseline PTSD severity did not moderate the association between modality and dropout; group advantage persisted across PTSD symptom levels.
Mil Psychol. 2026 Sep 24:1-11. doi: 10.1080/08995605.2026.2737914. Online ahead of print.
ABSTRACT
The present study aimed to examine dropout rates from individual versus group trauma-focused therapy among Israeli combat reservists seeking help following the October 7th War. This retrospective observational cohort study included 390 combat reservists treated in either individual (75.1%, n = 293) or group-based (24.9%, n = 97) trauma-focused therapy formats. Dropout was the dependent variable. Measures included the PCL-5, BSI-18, and POAMS. Time to dropout was analyzed using Cox proportional hazards regression, adjusting for demographic, military, and clinical covariates. Dropout rates varied substantially across modalities. Among individual therapies, rates ranged from 12.5% (PE) to 50.0% (CPT), while group interventions showed consistently lower rates, with group WET the lowest (7.84%). Individual therapy was associated with significantly higher dropout risk (HR = 2.58, 95% CI [1.40, 4.78], p = .003), remaining significant after adjustment (adjusted HR = 2.34, 95% CI [1.23, 4.46], p = .010). Baseline PTSD severity did not moderate this association when PCL-5 was modeled continuously (treatment modality × PCL-5: HR = 1.004, 95% CI [0.965, 1.043], p = .854), and the interaction remained non-significant after covariate adjustment (HR = 1.001, 95% CI [0.963, 1.040], p = .974). However, group-based trauma-focused therapy, and particularly group WET, was associated with significantly lower dropout rates compared to individual therapy among combat-exposed veterans. Importantly, this advantage persisted across varying levels of PTSD symptom severity at baseline. These findings have meaningful clinical implications for treatment planning in military populations.
PMID:42782183 | DOI:10.1080/08995605.2026.2737914
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