For PTSD Patients, Better Outcomes For Less Money If They Get To Choose Treatment

May 29, 2014

Letting patients with post-traumatic stress disorder choose how they want to be treated can produce better outcomes for less money, according to a new study co-written by a University of Washington psychologist.

Treating someone with PTSD often comes down to a question of whether they get counseling or pharmaceuticals. The new study offers some evidence about which one works better, but even stronger evidence that letting the patient make the choice produces the best outcomes for the least cost.

Prof. Lori Zoellner, director of UW’s Center for Anxiety and Traumatic Stress, said letting patients decide helps them get the treatment best suited for them, and also increases their buy-in to whichever option they go with.

"You're probably more likely to take your medication regularly, to attend your psychiatrist visits more regularly. And in psychotherapy, you may also be more likely to do the homework," she said.

The researchers found it cost less money to treat patients who got to choose – about $1,622 less per patient, per year in direct and indirect costs.  

Half the patients in the study got to choose between an antidepressant called sertraline (known by the brand name Zoloft) or a kind of talk therapy called prolonged exposure therapy. The other half of the patients were randomly assigned one or the other.

Among those assigned treatment, the study found that counseling was actually more cost-effective than medication. Zoellner said that will probably surprise a lot of people.

"Giving a medication, monitoring it, seems like it actually would be more cost-effective than seeing a psychotherapist routinely for a period of time. And it's actually the opposite," she said.

Zoellner said the findings could have major implications for health care systems like the Department of Veterans Affairs, which treat large numbers of people with PTSD. The study appears in the Journal of Clinical Psychiatry.