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The effectiveness of trauma-focused psychotherapy for complex post-traumatic stress disorder: A retrospective study

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posted on 2024-06-06, 10:07 authored by Eirini Melegkovits, Jocelyn Blumberg, Emily Dixon, Kimberley Ehntholt, Julia Gillard, Hamodi Kayal, Tim Kember, Livia Ottisova, Eileen Walsh, Maximillian Wood, Rafael Gafoor, Chris Brewin, Jo Billings, Mary Robertson, Michael Bloomfield

Objective We retrospectively evaluated the effectiveness of trauma-focused psychotherapy (TF-P) versus stabilization and waiting in a civilian cohort of patients with an 11th version of the international classification of disease (ICD-11) diagnosis of complex post-traumatic stress disorder (CPTSD). Methods We identified patients with CPTSD treated at a specialist trauma service over a 3-year period by triangulating evidence from self-report questionnaires, file review, and expert-clinician opinion. Patients completed a phase-based treatment: stabilization consisting of symptom management and establishing safety, followed by waiting for treatment (phase 1); individual TF-P in the form of trauma-focused cognitive behavioral therapy (TF-CBT), or eye movement desensitization and reprocessing (EMDR) or TF-CBT plus EMDR (phase 2). Our primary outcome was PTSD symptoms during phase 2 versus phase 1. Secondary outcomes included depressive symptoms, functional impairment, and a proxy CPTSD measure. Exploratory analysis compared outcomes between treatments. Adverse outcomes were recorded. Results Fifty-nine patients were included. Compared to receiving only phase 1, patients completing TF-P showed statistically significant reductions in PTSD [t(58) = −3.99, p < 0.001], depressive symptoms [t(58) = −4.41, p < 0.001], functional impairment [t(58) = −2.26, p = 0.028], and proxy scores for CPTSD [t(58) = 4.69, p < 0.001]. There were no significant differences in outcomes between different treatments offered during phase 2. Baseline depressive symptoms were associated with higher PTSD symptoms and functional impairment. Conclusions This study suggests that TF-P effectively improves symptoms of CPTSD. However, prospective research with validated measurements is necessary to evaluate current and new treatments and identify personal markers of treatment effectiveness for CPTSD.

History

Refereed

  • Yes

Volume

66

Issue number

1

Number of pages

9

Publication title

European Psychiatry

ISSN

0924-9338

Publisher

Royal College of Psychiatrists

Location

England

File version

  • Published version

Language

  • eng

Item sub-type

Journal Article

Media of output

Electronic

Affiliated with

  • School of Psychology and Sport Science Outputs