If we build it, will they come? And will they stay? Commentary on Holmes et al. “Examining patterns of dose response for clients who do and do not complete Cognitive Processing Therapy”


Although evidence-based practice is becoming more widely accepted, the issue of patient preference has been relatively ignored. As noted by Holmes and colleagues (2019), when delivered in a community setting, Cognitive Processing Therapy (CPT) can have a relatively high dropout rate (42 % in the Holmes et al., 2019). In this commentary, issues about the conceptualization of treatment dropout as one index of patient preference are discussed. Dropout can be conceptualized as a potential reflection of poor fit between the patient and a specific empirically-supported treatment. Consideration of ways in which an empirically-supported treatment can be personalized, while remaining true to its underlying principles, are discussed using CPT as an example.

Publication Title

Journal of Anxiety Disorders