CRITICAL ANALYSIS OF THE CURRENT TREATMENT GUIDELINES FOR COMPLEX PTSD IN ADULTS

Summary & key facts

This paper looked closely at the research behind the rule that adults with Complex PTSD should start therapy with a "stabilization phase" that teaches self-control skills before any trauma-focused treatment. The authors found the research behind that rule to be weak and not rigorous. They say there is no strong proof that a stabilization phase is needed, that trauma-focused treatments are too risky for people with Complex PTSD, or that people get much more benefit when stabilization comes first. Because of this, the current guidelines might be too cautious and could delay or block adults from getting conventional, evidence-based treatments that might help them.

Key facts:

• Current treatment guidelines for adults with Complex PTSD recommend beginning therapy with a stabilization phase that teaches self-regulation skills before trauma-focused treatment.
• The paper critically reviewed the research that supports this phase-based approach and found that the studies are methodologically limited, meaning they have weak or flawed designs.
• The authors found no rigorous evidence showing that a phase-based approach is necessary for positive treatment results in adults with Complex PTSD.
• They also found no strong proof that trauma-focused treatments carry unacceptable risks for adults with Complex PTSD or that these adults do not respond to such treatments.
• Because the evidence is weak, the paper cautions that guidelines requiring stabilization first may be too conservative and could delay or deny patients access to conventional evidence-based treatments.

Abstract

According to current treatment guidelines for Complex PTSD (cPTSD), psychotherapy for adults with cPTSD should start with a "stabilization phase." This phase, focusing on teaching self-regulation strategies, was designed to ensure that an individual would be better able to tolerate trauma-focused treatment. The purpose of this paper is to critically evaluate the research underlying these treatment guidelines for cPTSD, and to specifically address the question as to whether a phase-based approach is needed. As reviewed in this paper, the research supporting the need for phase-based treatment for individuals with cPTSD is methodologically limited. Further, there is no rigorous research to support the views that: (1) a phase-based approach is necessary for positive treatment outcomes for adults with cPTSD, (2) front-line trauma-focused treatments have unacceptable risks or that adults with cPTSD do not respond to them, and (3) adults with cPTSD profit significantly more from trauma-focused treatments when preceded by a stabilization phase. The current treatment guidelines for cPTSD may therefore be too conservative, risking that patients are denied or delayed in receiving conventional evidence-based treatments from which they might profit.

Topics

Child Abuse and Trauma Posttraumatic Stress Disorder Research Suicide and Self-Harm Studies

Categories

Clinical Psychology Psychology Social Sciences

Tags

Clinical psychology Intensive care medicine Medicine Psychology Psychotherapist

Conditions & symptoms

PTSD