Research and recovery: Can patient participation in research promote recovery for people with complex post-traumatic stress disorder, CPTSD?

BACKGROUND

A new diagnosis of complex post-traumatic stress disorder, CPTSD, has been agreed by the World Health Organization, WHO, and evidence is needed for what psychological treatment might be effective, particularly from those with experience of the disorder. We used a novel participatory approach to explore patient views and simultaneously studied the impact on the patient researchers of the research process itself. In this paper, we report on the latter section of the study how the involvement in research of patients with CPTSD affected their mental health. Symptoms of CPTSD may include emotional dysregulation, feelings of self-worthlessness and difficulties in relationships.

OBJECTIVE

The aim of this study section was to explore whether patients' mental health could be promoted through empowering them to participate in research on CPTSD.

DESIGN

The study had a qualitative, participatory design. The clinician who led the research (first author) held group meetings with patient researchers to explore the impact of the research process. The clinician also kept notes on the process in a reflective log.

SETTING AND PARTICIPANTS

Six patient researchers participated in research with other patients with lived experience of CPTSD in an NHS outpatient unit in a London hospital.

INTERVENTION STUDIED

The research process itself was analysed in group meetings with researchers which the clinician recorded and transcribed.

FINDINGS

Participation in research may promote increased self-confidence and social inclusion for those with CPTSD.

CONCLUSION

Involvement in research may be seen as an empowering intervention because patients felt it contributed to recovery.

A participatory study of patient views on psychotherapy for complex post-traumatic stress disorder, CPTSD

BACKGROUND

A new diagnosis of Complex Post-traumatic Stress Disorder, CPTSD, is included in ICD-11 which was adopted in May 2019 by the World Health Organisation, WHO. In addition to the symptoms of PTSD, CPTSD includes emotional dysregulation, negative self-concept, and disturbances in relationships. It may be a helpful diagnosis for trauma survivors with experiences of human mistreatment such as torture and abuse.

AIMS

This study explores the views of patients in the community on psychotherapy for the diagnosis of CPTSD, taking a qualitative, participatory approach.

METHOD

Twenty-four former patients from an NHS secondary mental health service in London interviewed each other about their treatment. Participants also collaborated in data analysis. All had a diagnosis of PTSD, with additional symptoms of CPTSD identified at assessment.

RESULTS

The key factor in recovery was rebuilding relationships, beginning with the therapist. Groupwork was helpful in promoting relationships with others, as it may result in shame reduction. Involvement in the wider community through peer support groups was also valuable.

CONCLUSIONS

The rebuilding of relationships based on trust was an active mechanism of change and recovery from CPTSD. Participants felt that sufficient time, at least one year of psychotherapy with weekly sessions, was needed.