Critical Analysis of the Current Treatment Guidelines for Complex PTSD in Adults

Ad De Jongh, Patricia A. Resick, Lori A. Zoellner, Agnes Van Minnen, Christopher W. Lee, Candice M. Monson, Edna B. Foa, Kathleen Wheeler, Erik Ten Broeke, Norah Feeny, Sheila A M Rauch, Kathleen M. Chard, Kim T. Mueser, Denise M. Sloan, Mark Van Der Gaag, Barbara Olasov Rothbaum, Frank Neuner, Carlijn De Roos, Lieve M J Hehenkamp, Rita RosnerIva A E Bicanic

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218 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)359-369
Number of pages11
JournalDepression and Anxiety
Issue number5
Publication statusPublished - 1 May 2016
Externally publishedYes


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