The DOI matches its Crossref record; 42 of the 42 references it cites were found in a registry or an index.
Treatment of complex PTSD: results of the ISTSS expert clinician survey on best practices.
Abstract
This study provides a summary of the results of an expert opinion survey initiated by the International Society for Traumatic Stress Studies Complex Trauma Task Force regarding best practices for the treatment of complex posttraumatic stress disorder (PTSD). Ratings from a mail‐in survey from 25 complex PTSD experts and 25 classic PTSD experts regarding the most appropriate treatment approaches and interventions for complex PTSD were examined for areas of consensus and disagreement. Experts agreed on several aspects of treatment, with 84% endorsing a phase‐based or sequenced therapy as the most appropriate treatment approach with interventions tailored to specific symptom sets. First‐line interventions matched to specific symptoms included emotion regulation strategies, narration of trauma memory, cognitive restructuring, anxiety and stress management, and interpersonal skills. Meditation and mindfulness interventions were frequently identified as an effective second‐line approach for emotional, attentional, and behavioral (e.g., aggression) disturbances. Agreement was not obtained on either the expected course of improvement or on duration of treatment. The survey results provide a strong rationale for conducting research focusing on the relative merits of traditional trauma‐focused therapies and sequenced multicomponent approaches applied to different patient populations with a range of symptom profiles. Sustained symptom monitoring during the course of treatment and during extended follow‐up would advance knowledge about both the speed and durability of treatment effects.
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In the citing paper
“On the other hand, ISTSS guidelines indicate sufficient evidence and clinical rationale to support the phase-oriented approach with an initial period of stabilization and establishment of safety (46, 84, 95).”
In the citing paper
“Attaining relative safety and stability is the foundation of stage 1 treatment of PTSD with complex presentations (complex PTSD), as well as dissociative disorders, which are highly linked to developmental traumas (46, 84–87).”
In the citing paper
“Clinical presentations that extend beyond those described by the ICD-10 diagnosis of PTSD, particularly among individuals who experienced extreme, prolonged or multiple forms of trauma, have been reported by clinicians and researchers over several decades 18,19 .”
In the citing paper
“The selection of specific symptoms and symptom clus ters reflecting difficulties in these domains was guided by the DESNOS formulation in the DSM-IV field trials 26 as well as by an expert consensus survey on complex PTSD 19 .”
Citations
Cites
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR)
American Psychiatric Association (2000) · doi:10.1176/appi.books.9780890423349 · Cited by 11,069
Diagnostic and Statistical Manual of Mental Disorders
Raber, G., & Spokas, M. (2024) · doi:10.4135/9781071886229.n145 · Cited by 2,806
Mendelson, G. (1995) · Australian & New Zealand Journal of Psychiatry · doi:10.3109/00048679509064964 · Cited by 2,592
Freeman, A. M. (2001) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v62n1112 · Cited by 1,667
Posttraumatic stress disorder: the burden to the individual and to society.
Kessler, R. C. (2000) · PubMed · Cited by 1,445
Disorders of extreme stress: The empirical foundation of a complex adaptation to trauma
van der Kolk, B. A., Roth, S., Pelcovitz, D., Sunday, S., & Spinazzola, J. (2005) · Journal of Traumatic Stress · doi:10.1002/jts.20047 · Cited by 1,284
Cloître, M., Koenen, K. C., Cohen, L. R., & Han, H. (2002) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.70.5.1067 · Cited by 1,099
Cloitre, M., Koenen, K. C., Cohen, L. R., & Han, H. (2002) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.70.5.1067 · Cited by 1,097
Albeck, J. H. (2001) · American Journal of Psychotherapy · doi:10.1176/appi.psychotherapy.2001.55.2.295 · Cited by 973
Dissociation, somatization, and affect dysregulation: the complexity of adaptation of trauma
van der Kolk, B. A., Pelcovitz, D., Roth, S., Mandel, F. S., McFARLANE, A. C., & Herman, J. L. (1996) · American Journal of Psychiatry · doi:10.1176/ajp.153.7.83 · Cited by 886
A Method for the Detailed Assessment of the Appropriateness of Medical Technologies
Brook, R. H., Chassin, M. R., Fink, A., Solomon, D. H., Kosecoff, J., & Park, R. E. (1986) · International Journal of Technology Assessment in Health Care · doi:10.1017/s0266462300002774 · Cited by 762
Treating complex traumatic stress disorders: An evidence-based guide.
Courtois, C. A., Norton-Ford, J. D., Herman, J. L., & van der Kolk, B. A. (2009) · Cited by 710
Self-citationTreatment for PTSD Related to Childhood Abuse: a Randomized Controlled Trial
Cloitre, M., Stovall-McClough, K. C., Nooner, K., Zorbas, P., Cherry, S., Jackson, C. L., Gan, W., & Petkova, E. (2010) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2010.09081247 · Cited by 642 · cited 2×
“One of the latter studies (Cloitre et al., 2010) conducted a head-to-head contrast of a phase-based treatment compared to two separate conditions each representing a single phase of the combined approach-stabilization phase only or trauma-focused phase only.”
BackgroundResultDevelopment of a criteria set and a structured interview for disorders of extreme stress (SIDES)
Pelcovitz, D., van der Kolk, B. A., Roth, S., Mandel, F. S., Kaplan, S. J., & Resick, P. A. (1997) · Journal of Traumatic Stress · doi:10.1023/a:1024800212070 · Cited by 536
The cross-cultural validity of posttraumatic stress disorder: implications for DSM-5
Hinton, D. E., & Lewis‐Fernández, R. (2010) · Depression and Anxiety · doi:10.1002/da.20753 · Cited by 500
A critical review of psychological treatments of posttraumatic stress disorder in refugees
Nickerson, A., Bryant, R. A., Silove, D., & Steel, Z. (2011) · Clinical Psychology Review · doi:10.1016/j.cpr.2010.10.004 · Cited by 457
Chard, K. M. (2005) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.73.5.965 · Cited by 403
van der Kolk, B. A., Spinazzola, J., Blaustein, M. E., Hopper, J. W., Hopper, E. K., Korn, D. L., & Simpson, W. B. (2007) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v68n0105 · Cited by 403
Prolonged exposure in patients with chronic PTSD: predictors of treatment outcome and dropout
van Minnen, A., Arntz, A., & Keijsers, G. P. J. (2002) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(01)00024-9 · Cited by 393
Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision
International Society for the Study of Trauma and Dissociati (2011) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2011.537247 · Cited by 374
Bisson, J. I., Ehlers, A., Pilling, S., Dix, P., Murphy, A. W., Johnston, J. M., Richards, D. A., Turner, S. W., Yule, W., Jones, C., et al. (2005) · ORCA Online Research @Cardiff (Cardiff University) · Cited by 352
Gender differences in the epidemiology and treatment of anxiety disorders.
Pigott, T. A. (1999) · PubMed · Cited by 348
The expert consensus guideline series : treatment of posttraumatic stress disorder
Foa, E. B., Davidson, J. R. T., FRANCES, A. J., Culpepper, L., ROSS, R. W., & Ross, D. F. (1999) · The Journal of Clinical Psychiatry · Cited by 338
Forbes, D., Creamer, M. C., Phelps, A. J., Bryant, R. A., McFARLANE, A. C., Devilly, G. J., Matthews, L. R., Raphael, B., Doran, C. M., Merlin, T., et al. (2007) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670701449161 · Cited by 336
Treatment of complex posttraumatic self-dysregulation.
Lavasani, F., Courtois, C., Steele, K., van der Hart, O., & Nijenhuis, E. (2005) · Journal of Traumatic Stress · doi:10.1002/jts.20051 · Cited by 258
Self-citationSteil, R., Dyer, A., Priebe, K., Kleindienst, N., & Bohus, M. (2011) · Journal of Traumatic Stress · doi:10.1002/jts.20617 · Cited by 205
Zlotnick, C., Shea, M. T., Rosen, K., Simpson, E. B., Mulrenin, K., Begin, A., & Pearlstein, T. B. (1997) · Journal of Traumatic Stress · doi:10.1023/a:1024841321156 · Cited by 198
Resick, P. A., Nishith, P., & Griffin, M. G. (2003) · CNS Spectrums · doi:10.1017/s1092852900018605 · Cited by 163
Psychological Healing. A Historical and Clinical Study
&NA;, &. (1926) · Southern Medical Journal · doi:10.1097/00007611-192610000-00029 · Cited by 141
Cognitive-behavioral Therapy with Adults
Reinecke., S. G. H. A. M. A. (2010) · Cambridge University Press eBooks · doi:10.1017/cbo9780511781919 · Cited by 135
Group therapy for incarcerated women who experienced interpersonal violence: A pilot study
Bradley, R. G., & Follingstad, D. R. (2003) · Journal of Traumatic Stress · doi:10.1023/a:1024409817437 · Cited by 130
Psychological healing : a historical and clinical study
Janet, P. F. M. (1976) · Arno Press eBooks · Cited by 121
DESNOS in three postconflict settings: Assessing cross-cultural construct equivalence
de Jong, J. T. V. M., Komproe, I. H., Spinazzola, J., van der Kolk, B. A., & van Ommeren, M. (2005) · Journal of Traumatic Stress · doi:10.1002/jts.20005 · Cited by 117
Classen, C. C., Palesh, O. G., Cavanaugh, C. E., Koopman, C., Kaupp, J. W., KRAEMER, H. C., Aggarwal, R., & Spiegel, D. (2010) · Psychological Trauma Theory Research Practice and Policy · doi:10.1037/a0020096 · Cited by 101
Complex Sequelae of Psychological Trauma Among Kosovar Civilian War Victims
Nexhmedin Morina, B., & Ford, J. D. (2008) · International Journal of Social Psychiatry · doi:10.1177/0020764008090505 · Cited by 76
Trauma Symptom Inventory (TSI)
(2013) · PsycEXTRA Dataset · doi:10.1037/e568012010-001 · Cited by 61
Dorrepaal, E., Thomaes, K., Smit, J. H., van Balkom, A. J. L. M., van Dyck, R., Veltman, D. J., & Draijer, N. (2010) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2009.07.003 · Cited by 60 · cited 1×
“Three evaluated the benefits of stabilizing and rehabilitative programs without the use of trauma-focused components (Bradley & Follingstad, 2003; Dorrepaal et al., 2010; Zlotnick et al., 1997); four included a trauma-focused component integrated with a sequenced (Cloitre, Koenen, Cohen, & Han,…”
BackgroundConsensus methods in practice guideline development: a review and description of a new method.
Kahn, D. A., Docherty, J. P., Carpenter, D., & Frances, A. (1997) · PubMed · Cited by 55
Do Assault-Related Variables Predict Response to Cognitive Behavioral Treatment for PTSD?
Hembree, E. A., Street, G. P., Riggs, D. S., & Foa, E. B. (2004) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.72.3.531 · Cited by 55
A pilot study of meditation for mental health workers following Hurricane Katrina
Waelde, L. C., Uddo, M. M., Marquett, R. M., Ropelato, M., Freightman, S., Pardo, A., & Salazar, J. (2008) · Journal of Traumatic Stress · doi:10.1002/jts.20365 · Cited by 53
Beltran, R. O., & Silove, D. (1999) · Comprehensive Psychiatry · doi:10.1016/s0010-440x(99)90147-5 · Cited by 50
Working with refugees and asylum seekers
Turner, S. W., & Herlihy, J. (2009) · Psychiatry · doi:10.1016/j.mppsy.2009.05.002 · Cited by 22
Research works printed but not linked: 6
- Foa E. B., 1995, Posttraumatic Stress Diagnostics Scale
- Herman J. L., 1992, Trauma and recovery: The aftermath of violence from domestic violence to political terrorism
- Institute of Medicine, 2008, Treatment of posttraumatic stress disorder: An assessment of the evidence
- 10.1002/jts.2490100103 · DOI
- Steele K., 2009, Treating complex traumatic stress disorders: An evidence‐based guide, 145
- 10.1002/jts.2490100308 · DOI
Cited by
Sorted by citations
Cloitre, M., Shevlin, M., Brewin, C. R., Bisson, J. I., Roberts, N. P., Maercker, A., Karatzias, T., & Hyland, P. (2018) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12956 · Cited by 1,314
Katzman, M. A., Bleau, P., Blier, P., Chokka, P., Kjernisted, K., Van Ameringen, M., & the Canadian Anxiety Guidelines Initiative Group on behalf of the Anxiety Disorders Association of Canada/Association Canadienne des troubles anxieux and McGill University (2014) · BMC Psychiatry · doi:10.1186/1471-244x-14-s1-s1 · Cited by 1,090
“The guidelines include panic disorder, agoraphobia, specific phobia, social anxiety disorder (SAD), generalized anxiety disorder (GAD), as well as obsessive-compulsive disorder (OCD), and posttraumatic stress disorder (PTSD).”
BackgroundInfluentialPost-traumatic stress disorder.
Yehuda, R., Hoge, C. W., McFarlane, A. C., Vermetten, E., Lanius, R. A., Nievergelt, C. M., Hobfoll, S. E., Koenen, K. C., Neylan, T. C., & Hyman, S. E. (2015) · Nature Reviews Disease Primers · doi:10.1038/nrdp.2015.57 · Cited by 870
Diagnosis and classification of disorders specifically associated with stress: proposals for ICD-11
Maercker, A., Brewin, C. R., Bryant, R. A., Cloitre, M., van Ommeren, M., Jones, L. M., Humayan, A., Kagee, A., Llosa, A. E., Rousseau, C., et al. (2013) · World Psychiatry · doi:10.1002/wps.20057 · Cited by 762
Evidence for proposed ICD-11 PTSD and complex PTSD: a latent profile analysis
Cloitre, M., Garvert, D. W., Brewin, C. R., Bryant, R. A., & Maercker, A. (2013) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v4i0.20706 · Cited by 751
“…by the symptoms most frequently reported by participants in the DSM-IV field trials (see Van der Kolk, Roth, Pelcovitz, Sunday & Spinazzola, 2005) as well those identified as most frequent and most impairing by expert clinicians in a recent consensus survey on complex PTSD (Cloitre et al., 2011).”
BackgroundMethod
Metadata
- Authors
- Cloitre, M., Courtois, C. A., Charuvastra, A., Carapezza, R., Stolbach, B. C., & Green, B. L.
- Affiliations
- Nathan Kline Institute for Psychiatric Research (US)
- New York University (US)
- University of Chicago (US)
- Georgetown University (US)
- Venue
- Journal of Traumatic Stress
- Publisher
- Wiley
- Published
- 2011-12
- Volume
- 24
- Issue
- 6
- Pages
- 615-627
- ISSN
- 0894-9867 (ISSN-L)
- 1573-6598
- OpenAlex
- W2060194889
- Semantic Scholar
- 66c85744f58c1baa8a14113872bcade4c5c0efab
- Cited by
- 593
- References
- 42
- Citations by year
- 2026: 31 · 2025: 48 · 2024: 34 · 2023: 40 · 2022: 38 · 2021: 46 · 2020: 56 · 2019: 54 · 2018: 39 · 2017: 54 · 2016: 40 · 2015: 30 · 2014: 36 · 2013: 35 · 2012: 9
- FWCI
- 27.63
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Traumatic Stress (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- complex PTSD, expert consensus, trauma-focused psychotherapy, emotion regulation, trauma narration, cognitive restructuring, mindfulness, meditation, interpersonal skills training, aggression, treatment duration, symptom monitoring
- MeSH terms
- Female, Health Personnel, Humans, Male, Practice Patterns, Physicians', Stress Disorders, Post-Traumatic, United States, Health Care Surveys
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