Engagement and completion of evidence-based psychotherapy for PTSD among American Indian/Alaska Native, Latino, and White veterans.

OBJECTIVE: Among psychotherapeutic treatments for posttraumatic stress disorder, prolonged exposure, and cognitive processing therapy have distinguished themselves with their high efficacy and strong backing in the treatment literature. However, low patient retention undermines the benefit of these evidence-based psychotherapies. Underrepresentation of Latinx and American Indian/Alaska Native (AI/AN) veterans in posttraumatic stress disorder research has rendered it difficult to determine ethno-racial disparities in patient retention. Despite serving in the U.S. military at high rates, Latino and AI/AN veterans are especially underrepresented in the existing research regarding engagement and efficacy of evidence-based psychotherapies for posttraumatic stress disorder. METHOD: This study examined treatment selection, initiation, receipt of minimally adequate care, and completion among 708 male White, Latino, and AI/AN veterans seeking prolonged exposure or cognitive processing therapy in an outpatient Veterans Health Administration specialty clinic. RESULTS: Analyses revealed levels of treatment retention differed significantly between ethnoracial groups. After selecting treatment, AI/AN veterans were more likely to never attend any protocol sessions and had a shorter time to attrition compared with White veterans. CONCLUSION: The results of this study demonstrate barriers to treatment engagement and retention experienced by different ethnoracial groups and inform culturally sensitive considerations.