Understanding treatments of PTSD and C-PTSD: Info for Healthcare Professionals

Understanding treatments of PTSD and C-PTSD: Info for Healthcare Professionals

In the UK, it’s estimated that around 6,665,000 people are affected by Post Traumatic Stress Disorder, yet it is still an incredibly misunderstood, often misdiagnosed and stigmatised condition.

This lack of understanding and the misinformation that often circulates leads to the worrying fact that up to 70% of people with PTSD in the UK do not receive any professional help at all – despite it being a condition which can affect every area of one’s life. 

So the question must be asked then, why do some people not get help if it is such a debilitating condition? There are a variety of reasons.

Some people may realise they are struggling to cope after a trauma, but are unaware they have a diagnosable condition. They may feel that their symptoms are just part of their life now – even if they’re debilitating and affect every part of their life.

For others who have a PTSD or complex PTSD (C-PTSD) diagnosis, they may not know that treatments to help them recover are available. Just over a decade ago, people still thought that PTSD and C-PTSD were incurable conditions, but more recent evidence and research proves it is possible for PTSD and C-PTSD to be successfully treated many years after the traumatic event occurred – but the treatment options are not as well-known as they need to be, and many medical professionals are simply not able to keep up to date with current treatment options.

Additionally, people with PTSD and C-PTSD are often misdiagnosed as they can develop additional disorders such as depression, substance abuse, problems of memory and cognition, and other problems of physical and mental health. These co-morbid conditions are what gets diagnosed, and the PTSD is left to get worse in many cases.

We provide this information for health professionals in the hope that any clients and patients who may be displaying symptoms are able to be given swift and accurate information to help guide them to a sustained and effective recovery.

There are a variety of options to support someone affected by PTSD or C-PTSD and it depends on the time since trauma, severity and any other interventions that they may need (such as assistance with alcohol or narcotics dependence or other co-morbid conditions).

For some sufferers, the first step may be ‘watchful waiting,’ – which simply involves monitoring their symptoms to see if they improve or get worse. This is usually done if the trauma occurred recently, as for 2 in every 3 people who develop problems after a traumatic experience improve within a few weeks without treatment.

Additionally, some people might explore therapeutic options such as individual or group therapy like counselling or talking therapies. Often, this is used where someone is struggling to identify their trauma (if they have been through multiple traumas), needs assistance getting to a place where they’re ‘ready’ to begin treatment, has chosen not to have trauma-focused psychological treatment, needs support while waiting to get to a place of safety (physically and emotionally), they’ve gained little or no benefit from a course of trauma-focused psychological treatment, or simply needs help managing symptoms until treatment can begin.

If PTSD requires treatment, psychological therapies are usually recommended first, although a combination of a psychological therapy and medication may be recommended if severe or persistent PTSD is present.

NICE guidance (updated in 2018) currently recommends trauma-focused psychological treatments such as Eye Movement Desensitisation Reprocessing (EMDR), and trauma-focused cognitive behavioural therapy (CBT) as the main form of treatment for PTSD and C-PTSD.

Eye Movement Desensitisation Reprocessing is a psychotherapy treatment that has been extensively researched and proven effective to help millions of people of all ages recover from both PTSD and C-PTSD and the problems they cause, like flashbacks, upsetting thoughts or images, hypervigilance and other symptoms. The goal of EMDR is to allow the person to achieve a complete state of emotional and mental health – they should be able to recall or discuss the event without having a response that results in a debilitating reaction.

The treatment uses eye movements and sometimes audio tones, or even small hand-held buzzers to repeatedly stimulate the left and ride hemispheres of the brain to properly process traumatic intense and debilitating memories into simple memories.

One of the things many people really like about EMDR is that they don’t need to talk about their trauma.  People undergoing treatment are asked initially to only think about their traumatic experiences during a session – there’s no requirement to discuss them.  Given the reluctance and fear of many trauma survivors to talk about the details of their experience, this can be a hugely important benefit of EMDR over other treatment options.

Brain scans have clearly demonstrated changes after EMDR therapy, returning the brain to more ‘normal’ functioning. The bottom line of EMDR outcome research is that clinical change can be both profound and efficient.

Trauma-focused Cognitive Behavioural Therapy is generally well known and a more widely used way to treat PTSD and C-PTSD and can be really powerful and effective.  CBT addresses the here and now of symptoms, it doesn’t necessarily go back over the initial cause of the PTSD or C-PTSD. CBT helps to adjust and re-align negative thoughts, feelings and behaviours that stop someone from enjoying a good quality of life.

‘Trauma-Focused CBT has several main components, which are often represented by using the acronym PRACTICE.

P – Psychoeducation and Parenting: The therapist educates the person and help them realise what trauma is and what its effects are, including the behavioural and emotional responses that it tends to trigger in people. This also involves helping them with behaviour management strategies.

R – Relaxation Methods: The therapist teaches the individual effective and healthy relaxation methods to reduce and manage stress. These relaxation techniques may include breathing exercises, guided imagery and progressive muscle relaxation.

A – Affective Expression and Regulation Skills: Trauma frequently causes intense emotions including anger, fear and sadness. The therapist addresses this by assisting the person in learning to identify and express these overwhelming emotions. The therapist also helps them develop healthy ways to soothe anxiety and other negative emotions on their own.

C – Cognitive Coping Skills and Processing: People often find trauma to be quite confusing, and they may have a tough time processing things in a healthy way. Therapists can help them understand the link between behaviours, thoughts and feelings along with recognising and rectifying inaccurate thoughts about it.

T – Trauma Narrative and Processing: Sharing the traumatic event and its effect can be done through verbal, written, artistic or symbolic narratives. This offers the person a way to express and process the trauma and connected experiences. The therapist guides them in creating their narrative by using exposure exercises.

I – In Vivo Exposure: One of the most effective ways to overcome fear and anxiety is through exposure instead of avoiding anything that is linked to the trauma. In vivo exposure involves gradually exposing the individual to things that remind them of the trauma. This approach helps decrease their negative emotional responses to those reminders. It also helps them find ways to manage their emotional reactions to unexpected or future reminders.

C – Conjoint Therapy Sessions: These therapy sessions concentrate on creating and maintaining a healthy relationship within a family setting. It gives both parties an opportunity to practice communication skills and talk about the trauma in a therapeutic environment.

E – Enhancing Personal Safety and Future Growth: It is crucial for individuals who have experienced trauma to develop personal safety skills and learn how to form healthy relationships. Ways to avoid future trauma and stay safe, as well as means to keep healing and growing, are all discussed.’

Many people undergoing treatment for PTSD or C-PTSD find that undertaking some other holistic therapies can really support their recovery journey. Practices such as Accelerated resolution therapy, Havening Technique, Music Therapy, Surfing & Ocean Therapy, Acupuncture, Rapid Stress Management Technique (RSMT), Narrative Exposure Therapy, Prolonged Exposure Therapy, Tension & Trauma Releasing Exercises, Solution-focused Hypnotherapy, Emotional Freedom Techniques (Tapping) and even Play Therapy for children can all be incredibly effective. Find out more about these here

In addition to this, the benefits of activities such as yoga, meditation, martial arts, running, hydrotherapy, writing and journaling, wild swimming, tai chi and even gardening are widely researched and proven forms of addressing symptoms of PTSD and C-PTSD too.

In addition to those suffering with PTSD or C-PTSD (and those around them), it’s vital that healthcare professionals are aware of all of the causes and symptoms to look out for in their patients to avoid misdiagnosis, incorrect treatments and to provide the best resources for their patients.

With PTSD, knowledge IS power, and understanding that treatment exists, and more importantly works can provide so much hope to sufferers – so if you’d like more information to be able to support your patients and clients, please do not hesitate to get in touch, or find out more on our website.

If you or your workplace would be willing to have a stand with/hand out leaflets and booklets about PTSD – please do drop us an email with your name, address and some information about what you need.


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Treatments for PTSD

It is possible for PTSD to be successfully treated many years after the traumatic event occurred, which means it is never too late to seek help. For some, the first step may be watchful waiting, then exploring therapeutic options such as individual or group therapy – but the main treatment options in the UK are psychological treatments such as Eye Movement Desensitisation Reprogramming (EMDR) and Cognitive Behavioural Therapy (CBT).

Traumatic events can be very difficult to come to terms with, but confronting and understanding your feelings and seeking professional help is often the only way of effectively treating PTSD. You can find out more in the links below, or here.