[Stabilisation in trauma treatment: necessity or myth?]

Area of Science:

• Psychiatry
• Psychotherapy
• Trauma Studies

Background:

• Childhood interpersonal trauma can lead to complex post-traumatic stress disorder (cPTSD).
• A stabilization phase, teaching emotion regulation skills, is often recommended before trauma exposure therapy for cPTSD.
• There is ongoing debate regarding the necessity of this preparatory phase.

Purpose of the Study:

• To evaluate the empirical evidence for a phase-based treatment approach in patients with cPTSD.
• To determine if a stabilization phase is essential before trauma-focused therapy for childhood interpersonal trauma survivors.

Main Methods:

• Critical evaluation of existing scientific literature and guidelines.
• Review of studies underpinning the Expert Consensus Guidelines for Complex PTSD.

Main Results:

• Trauma-focused treatment, with or without a preceding stabilization phase, demonstrates effectiveness for cPTSD symptoms.
• Compelling evidence mandating a stabilization phase before evidence-based trauma-focused treatment is lacking.
• The effectiveness of trauma-focused therapy is not diminished by the absence of a preparatory stabilization phase.

Conclusions:

• Expert opinion is divided on optimal cPTSD treatment following childhood interpersonal trauma.
• The severity and complexity of cPTSD symptoms do not preclude trauma-focused treatment without a mandatory stabilization period.
• National guidelines recommending stabilization should not prevent patients from receiving timely trauma-focused therapy if indicated.