Edinburgh Napier University

  ICD-11 complex PTSD (CPTSD) is a new condition and therefore there are as yet no clinical trials evaluating interventions for its treatment. In this paper, we provide the rationale for a flexible multi-modular approach to the treatment of CPTSD, its feasibility and some evidence suggesting its potential benefits. The approach highlights flexibility in the selection of empirically-supported interventions (or set of interventions) and the order of delivery based on symptoms that are impairing, severe and of relevance to the patient. The approach has many potential benefits. It can incorporate the use of interventions for which there is already evidence of efficacy allowing the leveraging of past scientific efforts. It is also consistent with patient-centered care which highlights the importance of patient choice in identification of the problems to target, interventions to select and outcomes to monitor. Research on modular treatments with other disorders has found that compared to disorder-specific manualized protocols, flexible multi-modular treatment programs are superior in resolving identified problems and are associated with greater therapist and reduced patient burden. We briefly identify types of interventions that have been successful in treating trauma-exposed populations along with emerging interventions that are relevant to the particular problems associated with exposure to complex trauma and conclude with examples of how such treatments can be organized and tested. Research is now urgently needed on the effectiveness of existing and new intervention approaches to ICD-11 CPTSD treatment.