Critical analysis of the current treatment guidelines for complete PTSD in adults

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.

Journal

English

Ad de Jongh
Patricia A. Resick
Lori A. Zoellner
Agnes van Minnen
Christopher W. Lee
Candice M. Monson
Kathleen Wheeler
Erik ten Broeke
Norah Feeny
Sheila A. M. Rauch
Kathleen M. Chard
Kim T. Mueser
Denise M. Sloan
Mark van der Gaag
Barbara Olasov Rothbaum
Frank Neuner
Carlijn de Roos
Lieve M. J. Hehenkamp
Rita Rosner
Iva A. E. Bicanic

de Jongh, A., Resick, P. A., Zoellner, L. A., van Minnen, A., Lee, C. W., Monson, C. M., ... Bicanic, I. A. E. (2016). Critical analysis of the current treatment guidelines for complete PTSD in adults. Depression and Anxiety, 1–11.  doi:10.1002/da.22469