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Creating ‘living’ guidelines for PTSD

News, Research, Clinical practice
image of ptsd guidelines booklets

In 2007, Phoenix Australia developed the first Australian guidelines for the treatment of posttraumatic stress disorder. Now they are being developing into ‘living’ guidelines that will be continually updated with new evidence.

When Phoenix Australia developed the first posttraumatic stress disorder (PTSD) treatment guidelines, the aim was simple. They were designed to ‘support high quality treatment of people with PTSD by providing a framework of best practice around which to structure treatment’.

In 2013, the Guidelines were updated to embrace new evidence in the field, and they were broadened to include treatment options for children and adolescents, as well as adults affected by trauma.

The Guidelines are now in their next evolution – moving online and becoming ‘living’ guidelines that will be updated more often as new evidence about the effective treatment of PTSD emerges around the world.

As from the start, the Guidelines have been developed to help health practitioners, policy makers, and those affected by PTSD to make decisions about screening, assessment, referral, and treatment for PTSD and for acute stress disorder.

With a vast amount of information published about PTSD, the Guidelines are a way of providing health care providers and the people they treat with accurate information to help guide them towards the most effective treatment options.

The development of the Guidelines is a collaborative exercise with Phoenix Australia working with research and clinical experts in the PTSD field, people with lived experience of PTSD, general practitioners, social workers, and psychologists. A methodologist with expertise in guideline development is also on hand to guide the process.

“Phoenix Australia brings together this diverse group of people who represent all those who will uses the Guidelines, to consider the research about what works when it comes to prevention and treatment of acute stress disorder and PTSD, and balance that with real life and practical issues to be considered in implementation,” says Associate Professor Andrea Phelps, Deputy Director of Phoenix Australia.

“The Guideline Development Group drafts a set of recommendations that then go out to public consultation. It is a very rigorous process.”

For the first time, the Guidelines will also cover complex PTSD. “There has been increasing recognition that the mental health impacts of prolonged and repeated exposure to trauma may be more complex than the mental health outcomes of single incident trauma and there’s debate within the field about whether we need treatments specific to complex PTSD, or whether evidence-based treatments for PTSD still apply to complex PTSD.

“This is a new diagnosis for which there isn’t yet any treatment outcome research, so at our meeting in July the guideline development group considered the most relevant and important information we can provide to the field on complex PTSD,” says Associate Professor Phelps.

As well as addressing complex PTSD for the first time, the third and latest guidelines will be published online, rather than in their usual format.

Associate Professor Phelps says the National Health and Medical Research Council (NHMRC) that approves clinical guidelines has been moving towards the living guideline format and so it’s a natural progression for the PTSD Guidelines to follow suit.

“Guidelines can soon become out of date if they are only updated every five years (as has been the practice).

“With the living guidelines, you don’t have to renew the whole guideline but instead update sections as new information and research becomes available.”

The living guideline is due to be released later this year. It will bring benefits for health practitioners and for people with PTSD.

“Health practitioners can be sure that the recommendations in the Guidelines are always current,” says Associate Professor Phelps. “And patients can access the Guidelines online to become more informed so they can speak to their practitioner about whether the treatment they are getting is best practice.”

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