Treating Adults With Complex Posttraumatic Stress Disorder Using a Modular Approach to Treatment: Rationale, Evidence, and Directions for Future Research
Open accessAbstract
ICD‐11 complex PTSD (CPTSD) is a new condition, and, therefore, there are as yet no clinical trials evaluating interventions for its treatment. In this paper, we provide the rationale for a flexible multimodular approach to the treatment of CPTSD, its feasibility, and some evidence suggesting its potential benefits. The approach highlights flexibility in the selection of empirically supported interventions (or a set of interventions) and the order of delivery based on symptoms that are impairing, severe, and of relevance to the patient. The approach has many potential benefits. It can incorporate the use of interventions for which there is already evidence of efficacy allowing the leveraging of past scientific efforts. It is also consistent with patient‐centered care, which highlights the importance of patient choice in identification of the problems to target, interventions to select, and outcomes to monitor. Researchers on modular treatments of other disorders have found that, compared to disorder‐specific manualized protocols, flexible multimodular treatment programs are superior in resolving identified problems and are associated with greater therapist satisfaction and reduced patient burden. We briefly identify types of interventions that have been successful in treating trauma‐exposed populations as well as emerging interventions that are relevant to the particular problems associated with exposure to complex trauma. We conclude with examples of how such treatments can be organized and tested. Research is now urgently needed on the effectiveness of existing and new intervention approaches to ICD‐11 CPTSD treatment.
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- Authors
- Karatzias, T., & Cloitre, M.
- Affiliations
- NHS Lothian (GB)
- National Center for PTSD Dissemination and Training Division VA Palo Alto Health Care System & Stanford University Palo Alto California USA
- Corresponding author
- Karatzias, Thanos
- ORCID
- Karatzias, Thanos
- Venue
- Journal of Traumatic Stress
- Publisher
- Wiley
- Published
- 2019-11-15
- Volume
- 32
- Issue
- 6
- Pages
- 870-876
- ISSN
- 0894-9867 (ISSN-L)
- 1573-6598
- OpenAlex
- W2986299647
- Cited by
- 123
- References
- 35
- Citations by year
- 2026: 10 · 2025: 20 · 2024: 17 · 2023: 24 · 2022: 21 · 2021: 19 · 2020: 10 · 2019: 2
- FWCI
- 15.18
- Type
- journal article
- Language
- en
- Open access
- Locations
- Journal of Traumatic Stress (publishedVersion)
- PubMed (publishedVersion)
- Edinburgh Napier Research Repository (Edinburgh Napier University) (submittedVersion, cc-by)
- Research Output (Edinburgh Napier University) (submittedVersion, cc-by)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- complex PTSD, ICD-11, empirically supported treatments, treatment sequencing, patient-centered care, trauma exposure, complex trauma, treatment feasibility, therapist satisfaction, patient burden
- MeSH terms
- Humans, Patient Participation, Psychotherapy, Stress Disorders, Post-Traumatic, Patient-Centered Care, International Classification of Diseases
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