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Keywords:

  • NICE clinical guidance;
  • PTSD;
  • trauma;
  • traumatic stress services

Accessible summary

  • • 
    At some point in their life, most people experience an event which can be deemed traumatic. Following this experience however, only a minority develop severe and chronic psychological difficulties such as post-traumatic stress disorder (PTSD). For this minority, traumatic experience can have highly adverse consequences including a debilitating impact on individual psychosocial functioning, often with additional repercussions for the wider community.
  • • 
    Specialist care following psychological trauma in the United Kingdom is governed by the National Institute for Health and Clinical Excellence (NICE) Guidance for the treatment of PTSD whose recommended therapeutic treatment constitutes, in the first instance, Cognitive Behavioural Therapy alongside techniques of eye movement, desensitization and reprocessing, that focus on the traumatic event itself.
  • • 
    This survey study assessed the range and scope of specialist therapeutic traumatic stress services in the United Kingdom. 13 services in total were surveyed. Ten of the surveyed services were from within the National Health Service and three were non-statutory organizations.
  • • 
    The survey found that, in line with NICE guidance, the recommended therapeutic treatment of trauma-focussed cognitive behavioural therapy was the most common treatment, but that other therapeutic approaches, such as person-centred therapy, were also widely employed illustrating some divergence from NICE guidance and, arguably, evidence of professionals within specialised settings tailoring therapeutic practices to the perceived needs of individual clients.

Abstract

Specialist care following psychological trauma in the UK has, since 2005, been governed by the National Institute for Health and Clinical Excellence (NICE) Guideline 26, for the treatment of post-traumatic stress disorder. NICE guidance states that the preferred first-line treatment is trauma-focused cognitive behavioural therapy that incorporates techniques of eye movement, desensitization and reprocessing. In light of this guidance, the rationale for this survey was to assess the nature and scope of services available in UK specialist trauma services and range of available therapeutic approaches delivered. Thirteen organizations responded to the survey. Ten were NHS services and three were non-statutory organizations. Professional positions were primarily populated by psychologists. The total number of referrals to UK specialist trauma services surveyed in the 12 months prior to the survey was 2041 with a mean of 157. Trauma-focused cognitive behavioural therapy was the most common therapeutic treatment, but person-centred therapy was found to have increased in availability within specialist trauma services. This arguably reflects the widening availability of person-centred therapy in the improving access to psychological therapies initiative and perhaps suggests some divergence from more uniform cognitive and behavioural approaches within NHS therapy services. Implications for practice are discussed.