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.
authors: Department of Social Dentistry (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands.|School of Health Sciences, Salford University, Manchester, United Kingdom.
authors: Ad
authors: A
authors: De Jongh
authors: School of Medicine, Duke University, Durham, North Carolina.
authors: Patricia A
authors: PA
authors: Resick
authors: Department of Psychology, University of Washington, Seattle, Washington.
authors: Lori A
authors: LA
authors: Zoellner
authors: Behavioural Science Institute, Radboud University Nijmegen, NijCare, The Netherlands.|MHO 'Pro Persona', Centre for Anxiety Disorders Overwaal, Nijmegen, The Netherlands.
authors: Agnes
authors: A
authors: van Minnen
authors: School of Psychology and Exercise Science, Murdoch University, Western Australia, Australia.
authors: Christopher W
authors: CW
authors: Lee
authors: Department of Psychology, Ryerson University, Toronto, Ontario, Canada.
authors: Candice M
authors: CM
authors: Monson
authors: Department of Psychology, Center for the treatment and Study of Anxiety, University of Pennsylvania Perelman SOM, Philadelphia, Pennsylvania.
authors: Edna B
authors: EB
authors: Foa
authors: School of Nursing Fairfield University, Fairfield, Connecticut.
authors: Kathleen
authors: K
authors: Wheeler
authors: Private Practice for Cognitive Behavioural Therapy Deventer/Bathmen, The Netherlands.
authors: Erik ten
authors: ET
authors: Broeke
authors: Department of Psychological Sciences, Case Western Reserve University, Cleveland, Ohio.
authors: Norah
authors: N
authors: Feeny
authors: VA Ann Arbor Healthcare System, University of Michigan Medical School, Michigan, Massachusetts.
authors: Sheila A M
authors: SA
authors: Rauch
authors: Cincinnati VA Medical Center and University of Cincinnati, Cincinnati, Ohio.
authors: Kathleen M
authors: KM
authors: Chard
authors: Center for Psychiatric Rehabilitation, Boston University College of Health and Rehabilitation Sciences: Sargent College, Boston, Massachusetts.
authors: Kim T
authors: KT
authors: Mueser
authors: VA National Center for PTSD at VA Boston Healthcare System, Boston, Massachusetts.|Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts.
authors: Denise M
authors: DM
authors: Sloan
authors: Department of Clinical Psychology, VU University Amsterdam and EMGO Institute for Health and Care Research, Parnassia Psychiatric Institute, The Hague, The Netherlands, Amsterdam, The Netherlands.
authors: Mark
authors: M
authors: van der Gaag
authors: Department of Psychiatry, Emory University School of Medicine, Atlanta, Georgia.
authors: Barbara Olasov
authors: BO
authors: Rothbaum
authors: Department of Psychology, Bielefeld University, Bielefeld, Germany.
authors: Frank
authors: F
authors: Neuner
authors: Psychotrauma Center for Children and Youth, MHO Rivierduinen, Leiden, The Netherlands.
authors: Carlijn
authors: C
authors: de Roos
authors: National Psychotrauma Center for Children and Youth, University Medical Center Utrecht, Utrecht, The Netherlands.
authors: Lieve M J
authors: LM
authors: Hehenkamp
authors: Department of Psychology, Catholic University, Eichstätt-Ingolstadt, Germany.
authors: Rita
authors: R
authors: Rosner
authors: National Psychotrauma Center for Children and Youth, University Medical Center Utrecht, Utrecht, The Netherlands.
authors: Iva A E
authors: IA
authors: Bicanic
mesh_terms: D000328:Adult; D006801:Humans; D017410:Practice Guidelines as Topic; D011613:Psychotherapy / Q000379:methods*; D013313:Stress Disorders, Post-Traumatic / Q000628:therapy*
keywords: PTSD; complex PTSD; phase-based treatment; stabilization; treatment guidelines