Intensive trauma-focused treatment for PTSD and Complex PTSD in a public clinic: a feasibility study

Abstract

Background Intensive trauma-focused treatment (ITFT) has demonstrated robust results in treating post-traumatic stress disorder (PTSD) in specialized trauma centers. Whether this treatment is feasible in a non-specialized treatment facility has not been previously investigated. Objective This pilot study aimed to examine if an ITFT program is feasible in a non-trauma-specialized public treatment facility, where many therapists had limited experience with trauma-focused treatment. Methods Eighteen female patients diagnosed with PTSD or Complex PTSD (CPTSD), with multiple traumas and comorbidity, participated in an intensive 2-week (4 + 4 days) inpatient trauma treatment program that included Prolonged Exposure, Eye Movement Desensitization and Reprocessing, group psychoeducation, and physical activity, and that also used therapist rotation. The patients were assessed using a battery of validated self-report questionnaires and interviews before and after the intervention, and at 2 and 6 months post-treatment. Therapists' and ward staff's readiness to provide TFT was assessed with a questionnaire after participating in the program. Results All participants completed treatment. Individual session attendance was very high, and no significant adverse effects were reported. The reduction in PTSD symptoms was considerable and sustained, with 83% of the sample showing clinically reliable change at the 6-month follow-up. Half of patients with a CPTSD diagnosis and all patients with a PTSD diagnosis lost their diagnosis. Trauma-related negative cognitions also showed a statistically significant reduction from baseline to the 6-month follow-up. Treatment satisfaction was high, including measures of the individual treatment components, and therapist rotation. Both therapists and ward staff reported increased readiness to start TFT after participating in the project. Conclusions This feasibility study indicates that intensive trauma-focused treatment for PTSD and CPTSD is acceptable and associated with symptom improvement in a public treatment facility. Trial registration ClinicalTrials.gov identifier: NCT05342480. Date of registration: 2022-04-22.