Dropout has been identified as a significant problem among military populations seeking psychotherapy (Goetter et al., 2015; Hoge et al., 2014), yet an overall estimate of its exact prevalence and predictors does not exist. The aims of the current meta-analysis were to estimate outpatient psychotherapy dropout rates for this population and evaluate potential moderators of this event. In total, 283 articles-comprising data from 719,465 U.S. service members and veterans-met all inclusion criteria and were included in the meta-analysis. The average weighted dropout rate for all outpatient therapies was 25.6%, 95% CI [22.4%, 29.2%], and prediction interval [1.9%, 85.9%]. Furthermore, dropout was 27.0% for cognitive behavioral therapies (CBTs), 25.3% for trauma treatments, 27.6% for the Department of Veterans Affairs (VA), 28.9% for individual therapies, and 9.8% for intensive outpatient settings. Findings from metaregression analyses using mixed-effects models indicated that higher dropout was linked with the following after accounting for other moderators: younger age, CBTs, nonmanualized approaches, VA versus Department of Defense settings, individual versus group therapies, and weekly versus intensive outpatient formats. Dropout was not linked with other client, therapist, treatment, and research variables. Taken together, dropout estimates were obtained for a range of military populations and treatment characteristics, including theoretical orientation, presenting concern, setting, and therapy formats. These estimates may provide potential benchmarks for therapists, administrators, and policymakers serving military populations. Leveraging dropout prevention strategies with at-risk groups highlighted in this study may enhance mental health care outcomes for this high-need population. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

中文翻译：

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没有一个客户落下：对美国现役军人和退伍军人提前终止心理治疗的荟萃分析。


退学已被确定为寻求心理治疗的军人群体中的一个重大问题（Goetter 等，2015；Hoge 等，2014），但对其确切患病率和预测因素的总体估计尚不存在。当前荟萃分析的目的是估计该人群的门诊心理治疗退出率，并评估该事件的潜在调节因素。总共有 283 篇文章（包含来自 719,465 名美国现役军人和退伍军人的数据）符合所有纳入标准，并被纳入荟萃分析。所有门诊治疗的平均加权退出率为 25.6%、95% CI [22.4%, 29.2%] 和预测区间 [1.9%, 85.9%]。此外，认知行为疗法 (CBT) 的退出率为 27.0%，创伤治疗的退出率为 25.3%，退伍军人事务部 (VA) 的退出率为 27.6%，个体治疗的退出率为 28.9%，重症门诊治疗的退出率为 9.8%。使用混合效应模型进行元回归分析的结果表明，在考虑其他调节因素后，较高的辍学率与以下因素相关：年龄较小、CBT、非手动方法、退伍军人管理局与国防部设置、个人治疗与团体治疗以及每周与强化门诊形式。退出与其他客户、治疗师、治疗和研究变量无关。总而言之，我们获得了一系列军人群体和治疗特征的退出率估计值，包括理论方向、提出问题、环境和治疗形式。这些估计可能为为军人服务的治疗师、管理人员和政策制定者提供潜在的基准。 对本研究中强调的高危人群采取辍学预防策略可能会改善这一高需求人群的心理健康护理结果。 （PsycInfo 数据库记录 (c) 2024 APA，保留所有权利）。