Cost-effectiveness analysis of the treatment of posttraumatic stress disorder related to childhood abuse: Comparison of phase-based treatment and direct trauma-focused treatment
Description
Background
Policymakers, health insurers, and health care providers are becoming increasingly interested in cost-effectiveness analyses (CEA’s) when choosing between possible treatment alternatives, as costs for mental health care have been increasing in recent years.
Objective
The current study compared the cost-effectiveness and cost-utility of a phased-based treatment approach that included a preparatory stabilization phase with direct trauma-focused treatment in patients with PTSD and a history of childhood abuse.
Methods
A cost-effectiveness analysis was conducted based on data from a randomized controlled trial of 121 patients with PTSD due to childhood abuse. A phase-based treatment (Eye Movement Desensitization and Reprocessing [EMDR] therapy preceded by Skills Training in Affect and Interpersonal Regulation [STAIR]; n = 57) was compared with a direct trauma-focused treatment (EMDR therapy only; n = 64). The primary outcome of cost-effectiveness was the proportion of patients with remitted PTSD. Quality-adjusted life years (QALY) were used as the primary outcome measure for cost-utility analysis.
Results
Although the results of the cost-effectiveness analyses yielded no statistically significant differences between the two groups, the mean societal costs per patient differed significantly between the STAIR-EMDR and EMDR therapy groups (€19.599 vs. €13.501; M cost differences = €6.098, CI (95%) = [€117; €12.644]).
Conclusion
STAIR-EMDR is not cost-effective compared with EMDR-only therapy. Since trauma-focused treatment is less time-consuming, non-trauma-focused phase-based, treatment does not seem to be a viable alternative for the treatment of PTSD due to adverse childhood events.
Clinical trial registration https://onderzoekmetmensen.nl/nl/trial/22074, identifier NL5836.
Note: This article is part of the Research Topic - Present and Future of EMDR in Clinical Psychology and Psychotherapy, Volume III (2025).
Policymakers, health insurers, and health care providers are becoming increasingly interested in cost-effectiveness analyses (CEA’s) when choosing between possible treatment alternatives, as costs for mental health care have been increasing in recent years.
Objective
The current study compared the cost-effectiveness and cost-utility of a phased-based treatment approach that included a preparatory stabilization phase with direct trauma-focused treatment in patients with PTSD and a history of childhood abuse.
Methods
A cost-effectiveness analysis was conducted based on data from a randomized controlled trial of 121 patients with PTSD due to childhood abuse. A phase-based treatment (Eye Movement Desensitization and Reprocessing [EMDR] therapy preceded by Skills Training in Affect and Interpersonal Regulation [STAIR]; n = 57) was compared with a direct trauma-focused treatment (EMDR therapy only; n = 64). The primary outcome of cost-effectiveness was the proportion of patients with remitted PTSD. Quality-adjusted life years (QALY) were used as the primary outcome measure for cost-utility analysis.
Results
Although the results of the cost-effectiveness analyses yielded no statistically significant differences between the two groups, the mean societal costs per patient differed significantly between the STAIR-EMDR and EMDR therapy groups (€19.599 vs. €13.501; M cost differences = €6.098, CI (95%) = [€117; €12.644]).
Conclusion
STAIR-EMDR is not cost-effective compared with EMDR-only therapy. Since trauma-focused treatment is less time-consuming, non-trauma-focused phase-based, treatment does not seem to be a viable alternative for the treatment of PTSD due to adverse childhood events.
Clinical trial registration https://onderzoekmetmensen.nl/nl/trial/22074, identifier NL5836.
Note: This article is part of the Research Topic - Present and Future of EMDR in Clinical Psychology and Psychotherapy, Volume III (2025).
Format
Journal
Language
English
Original Work Citation
van Vliet, N. I., Stand, A. D., Huntjens, R., van Dijk, M. K., & de Jongh, A. (2024, June). Cost-effectiveness analysis of the treatment of posttraumatic stress disorder related to childhood abuse: Comparison of phase-based treatment and direct trauma-focused treatment. Frontiers in Psychology, 15. doi:10.3389/fpsyg.2024.1310372
Collection
Citation
“Cost-effectiveness analysis of the treatment of posttraumatic stress disorder related to childhood abuse: Comparison of phase-based treatment and direct trauma-focused treatment,” Francine Shapiro Legacy Library, accessed November 18, 2025, https://francineshapirolibrary.omeka.net/items/show/29621.