Trauma-Focused Therapy Discontinuation Rules and Mental Health Crisis Re-presentation in Ethiopian District Hospitals: A Regression Discontinuity Analysis of Session Cap Thresholds

Session caps in trauma-focused therapy function as discontinuation rules, yet their effect on crisis re-presentation remains unexamined in Ethiopian district hospitals. The analysis treats the indicator as a proxy for rule-driven discontinuation and estimates the discontinuity in measured values at the session cap threshold. The sample mean was 2.585 (SD = 1.493), with country values ranging from 0.50 in Cote d'Ivoire to 6.55 in Morocco. The regression discontinuity specification did not yield a statistically identifiable discontinuity at the threshold, and the model fit statistics were insufficient to support a causal interpretation. The results indicate that the available indicator does not capture the session cap mechanism with sufficient precision to estimate crisis re-presentation effects. Discontinuation rules in trauma-focused therapy require dedicated measurement rather than proxy indicators, and it specifies the design conditions under which a credible regression discontinuity analysis of session caps could be mounted in Ethiopian district hospitals.