Trauma clinicians' views of physical exercise as part of PTSD and complex PTSD treatment: A qualitative study

Physical exercise has the potential to be a helpful, adjunctive intervention for supporting people with post-traumatic stress disorder (PTSD) and complex PTSD (CPTSD). However, little is known about the views of clinicians on including physical exercise in treatment. We aimed to explore trauma clinicians' perspectives on the role of physical exercise in PTSD and CPTSD treatment and to understand key barriers and facilitators in recommending physical exercise as an adjunctive treatment. Twelve specialist trauma clinicians from across the UK were interviewed to explore their views on the role of physical exercise and the key barriers and facilitators in recommending it as an adjunctive treatment for PTSD and CPTSD. We used a qualitative explorative methodology with semi-structured interviews and analysed transcripts using reflexive thematic analysis. Trauma clinicians viewed physical exercise as a potentially beneficial supportive intervention for PTSD and CPTSD, and perceived several ways in which physical exercise could be included in the treatment process, with an individualised approach to care underpinning inclusion. However, there were also notable barriers to including exercise at environmental, client and clinician/service levels, including; limited access to exercise resources, client-related factors such as agoraphobia and physical health problems, clinician-related factors such as lack of confidence and training, and service-level factors such as gaps in service provision. The findings highlight the importance of considering individualised approaches to physical exercise interventions in trauma treatment. Addressing identified barriers, such as improving access to resources and providing training for clinicians, is crucial for successful integration of physical exercise into PTSD and CPTSD treatment protocols. This study underscores the need for further research to inform future policies and provide guidance for trauma clinicians on how to effectively incorporate physical exercise as an adjunctive treatment.