CRITICAL ANALYSIS of the CURRENT TREATMENT GUIDELINES for COMPLEX PTSD in ADULTS

Ad De Jongh; Patricia A. Resick; Lori A. Zoellner; Agnes Van Minnen; Christopher W. Lee; Candice M. Monson; Edna B. Foa; 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

doi:10.1002/da.22469

CRITICAL ANALYSIS of the CURRENT TREATMENT GUIDELINES for COMPLEX PTSD in ADULTS

Ad De Jongh^*, Patricia A. Resick, Lori A. Zoellner, Agnes Van Minnen, Christopher W. Lee, Candice M. Monson, Edna B. Foa, 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 RosnerIva A E Bicanic

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

6 Citations (Scopus)

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.

Original language	English
Pages (from-to)	359-369
Number of pages	11
Journal	Depression and Anxiety
Volume	33
Issue number	5
DOIs	https://doi.org/10.1002/da.22469
Publication status	Published - 1 May 2016

Keywords

complex PTSD
phase-based treatment
PTSD
stabilization
treatment guidelines

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De Jongh, A., Resick, P. A., Zoellner, L. A., Van Minnen, A., Lee, C. W., Monson, C. M., Foa, E. B., Wheeler, K., Broeke, E. T., Feeny, N., Rauch, S. A. M., Chard, K. M., Mueser, K. T., Sloan, D. M., Van Der Gaag, M., Rothbaum, B. O., Neuner, F., De Roos, C., Hehenkamp, L. M. J., ... Bicanic, I. A. E. (2016). CRITICAL ANALYSIS of the CURRENT TREATMENT GUIDELINES for COMPLEX PTSD in ADULTS. Depression and Anxiety, 33(5), 359-369. https://doi.org/10.1002/da.22469

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title = "CRITICAL ANALYSIS of the CURRENT TREATMENT GUIDELINES for COMPLEX PTSD in ADULTS",

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.",

keywords = "complex PTSD, phase-based treatment, PTSD, stabilization, treatment guidelines",

author = "{De Jongh}, Ad and Resick, {Patricia A.} and Zoellner, {Lori A.} and {Van Minnen}, Agnes and Lee, {Christopher W.} and Monson, {Candice M.} and Foa, {Edna B.} and Kathleen Wheeler and Broeke, {Erik Ten} and Norah Feeny and Rauch, {Sheila A M} and Chard, {Kathleen M.} and Mueser, {Kim T.} and Sloan, {Denise M.} and {Van Der Gaag}, Mark and Rothbaum, {Barbara Olasov} and Frank Neuner and {De Roos}, Carlijn and Hehenkamp, {Lieve M J} and Rita Rosner and Bicanic, {Iva A E}",

year = "2016",

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doi = "10.1002/da.22469",

language = "English",

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De Jongh, A, Resick, PA, Zoellner, LA, Van Minnen, A, Lee, CW, Monson, CM, Foa, EB, Wheeler, K, Broeke, ET, Feeny, N, Rauch, SAM, Chard, KM, Mueser, KT, Sloan, DM, Van Der Gaag, M, Rothbaum, BO, Neuner, F, De Roos, C, Hehenkamp, LMJ, Rosner, R & Bicanic, IAE 2016, 'CRITICAL ANALYSIS of the CURRENT TREATMENT GUIDELINES for COMPLEX PTSD in ADULTS', Depression and Anxiety, vol. 33, no. 5, pp. 359-369. https://doi.org/10.1002/da.22469

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AU - De Jongh, Ad

AU - Resick, Patricia A.

AU - Zoellner, Lori A.

AU - Van Minnen, Agnes

AU - Lee, Christopher W.

AU - Monson, Candice M.

AU - Foa, Edna B.

AU - Wheeler, Kathleen

AU - Broeke, Erik Ten

AU - Feeny, Norah

AU - Rauch, Sheila A M

AU - Chard, Kathleen M.

AU - Mueser, Kim T.

AU - Sloan, Denise M.

AU - Van Der Gaag, Mark

AU - Rothbaum, Barbara Olasov

AU - Neuner, Frank

AU - De Roos, Carlijn

AU - Hehenkamp, Lieve M J

AU - Rosner, Rita

AU - Bicanic, Iva A E

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N2 - 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.

AB - 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.

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KW - phase-based treatment

KW - PTSD

KW - stabilization

KW - treatment guidelines

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SN - 1091-4269

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JO - Depression and Anxiety

JF - Depression and Anxiety

IS - 5

ER -

CRITICAL ANALYSIS of the CURRENT TREATMENT GUIDELINES for COMPLEX PTSD in ADULTS

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Keywords

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