Understanding barriers in supporting service users with complex post-traumatic stress disorder: a pilot survey

Background: Experiences of complex trauma and complex post-traumatic stress disorder (CPTSD) may be associated with barriers to effective intervention for service users and providers.Objective: This investigation sought to identify barriers to intervention and support for individuals with CPTSD and their service providers.Method: A pilot survey on barriers to services for CPTSD was distributed to members of the International Society for Traumatic Stress Studies (ISTSS) Complex Trauma Special Interest Group (CTSIG). A total of 28 respondents provided quantitative ratings of potential barriers to CPTSD intervention and support, and qualitative opinion based on respondents' clinical and research experience. Quantitative data underwent descriptive analyses, and qualitative data were analysed using an inductive content analysis approach.Results: The majority of potential CPTSD-related barriers in this survey were perceived as 'usually' or 'almost always' barriers for service users and providers. The results highlighted CPTSD-related stigma/misunderstanding, inability to drive systemic change, and accessibility of resources as the most significant barriers to effective CPTSD intervention faced by service providers. The main perceived barriers facing individuals with CPTSD were access to supports and services, dissatisfaction with previous intervention(s), and availability of personal and resources. Qualitative remarks indicated relevant barriers in identification and recognition of CPTSD, availability of training, treatment challenge, misdiagnosis, vulnerability due to CPTSD experiences, structural barriers, and symptom-related difficulties.Conclusion: These findings extend our understanding of expert opinion related to CPTSD intervention barriers, and offer indicative directions for future research. Extension of these results is needed to integrate the opinions of more diverse expert groups.