Expert international trauma clinicians' views on the definition, composition and delivery of reintegration interventions for complex PTSD.
Expert international trauma clinicians' views on the definition, composition and delivery of reintegration interventions for complex PTSD.
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DOI：
10.1080/20008066.2023.2165024
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发表时间：
2023
影响因子：
5
通讯作者：
Billings, Jo
中科院分区：
文献类型：
--
作者：
Condon, Maria;Bloomfield, Michael A. P.;Nicholls, Helen;Billings, Jo
背景资料：先前的研究已经区分了复杂的创伤后应激障碍（CPTSD）和PTSD，前者包括一系列自我调节能力的障碍以及与PTSD相关的困难。临床指南以前曾建议采用基于阶段的方法治疗CPTSD，但研究中忽略了治疗的最后“重返社会”阶段，其价值和有效性的证据有限，并且其定义和理解不一致。目的：我们着手界定和确定“重返社会”的主要原则，并具体说明治疗的组成部分和提供方法。方法：在CPTSD领先的国家和国际临床和学术专家进行了采访，并询问他们的意见，如何“重返社会”应该被定义，它在CPTSD治疗中的作用，它应该由什么组成，它的交付的关键原则，以及它应该如何进行评估。我们分析的采访记录的原则代码本主题分析。结果：我们与国内和国际领先的专家进行了16次访谈，这些专家至少有10年治疗CPTSD患者的经验。从我们的分析得出的主题表明，虽然专家之间的定义和重返社会的组成差异很大，其交付的关键原则是一致的所有专家。结论：这项研究的结果奠定了基础的框架，什么是重返社会，以及如何可以使用，但也强调需要进行更多的研究重返社会的作用，在治疗CPTSD。关于重返社会的定义和组成，尚未达成共识。今后还应探讨评估重返社会的可能措施。重返社会是CPTSD治疗的建议阶段之一，但最近的研究发现，其定义，作用和价值存在不一致。目前的研究表明了专家们的意见，突出了在重返社会的定义、组成和主要原则方面达成共识的领域以及意见分歧。
Background: Research has previously distinguished between complex post-traumatic stress disorder (CPTSD) and PTSD, with the former including a range of disturbances in self-regulatory capacities in addition to difficulties associated with PTSD. Clinical guidelines have previously recommended a phase-based approach for the treatment of CPTSD, yet the final ‘reintegration’ phase of treatment has been overlooked in research, with limited evidence into its value and effectiveness, and inconsistencies in its definitions and understanding. Objective: We set out to define and determine the key principles of ‘reintegration’ and to specify the components and method of delivery of treatment. Method: Leading national and international clinical and academic experts in CPTSD were interviewed and asked about their views of how ‘reintegration’ should be defined, its role in the treatment of CPTSD, what it should be composed of, the key principles of its delivery, and how it should be evaluated. We analysed transcripts of the interviews following the principles of Codebook Thematic Analysis. Results: We conducted 16 interviews with leading national and international experts with at least 10 years’ experience of treating people with CPTSD. Themes derived from our analysis demonstrated that while the definition and composition of reintegration varied greatly between experts, the key principles in its delivery were consistent across all experts. Conclusions: The results of this study lay the foundation for a framework of what reintegration is and how it can be used in, but also highlight the need for more research to be conducted on the role of reintegration in the treatment of CPTSD. Consensus for the definition and composition of reintegration is still yet to be reached. Possible measures for evaluating reintegration should also be explored in the future. Reintegration is one of the recommended phases of treatment for CPTSD, however recent research has found that there are inconsistencies in its definition, role and value. The current study shows the opinions of experts, highlighting areas of consensus as well as differences in views with regards to the definition, composition and key principles in the delivery of reintegration.
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