Treatment as usual psychological therapy for complex post-traumatic stress disorder in National Health Services in...

With Complex Post Traumatic Stress Disorder (CPTSD) as a new diagnostic category, there is a diversity of interventions and influences on clinical practice, it is prudent that we gather information about current 'treatment as usual'. This study aims to address this need by describing the current clinical landscape of CPTSD treatments offered in NHS services in Scotland.

An online survey was distributed via heads of service managers to clinicians working with adults. The survey posed questions about psychological therapy models, professional experience and, for the clinicians' latest 3 discharged cases, the length of therapy and perceived patient outcomes.

Forty-nine clinicians, most of whom were clinical psychologists, took part and provided data about 139 clinical cases. Twenty-three different therapeutic models were cited by clinicians, with phase-based approaches described by 64% of clinicians. The modal number of sessions was 21-30. Most cases were described as completed, with 28% ending before therapy was completed, and a further 7% dropped out. Of those who completed therapy, 86% were judged to have improved after therapy, with 11% judged to have deteriorated.

There is a wide variety of treatments available for complex PTSD, and innovative interventions and trials are required to support future clinical decision-making about the optimal treatment components and therapy length.