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Tijdschrift voor Psychiatrie 57 (2015) 5, 332 - 339

Review article

Stabilisation in trauma treatment: necessity or myth?

I. Bicanic, A. de Jongh, E. ten Broeke

background With regard to the treatment of patients who have been traumatised in childhood by interpersonal trauma and have been diagnosed as having symptoms of complex ptsd, it is advisable that exposure of such patients to traumatic memories should be preceded by a stabilisation phase: during this phase patients can be taught various techniques including particularly those that enable them to regulate their emotions.
aim To find out whether there is strong empirical evidence for the introduction of a phase-based treatment approach for this patient group.
method We performed a critical evaluation of the available scientific literature and guidelines. We took as our starting point the studies that formed the basis of the Expert Consensus Guidelines for Complex ptsd.
results Our research shows that trauma-focused treatment, be it with or without a preparatory stabilisation phase, is also effective for patients with complex ptsd symptoms. However, there is certainly no compelling evidence to support the assumption that well-organised and carefully administered evidence-based treatment has to be preceded by a stabilisation phase.
conclusion Among the experts there is uncertainty about the best form of treatment for patients with complex ptsd that has resulted from interpersonal trauma in childhood. For the time being, the severity and complexity of trauma-related problems are not valid reasons for denying patients a period of stabilisation as recommended in national treatment guidelines, nor are they valid reasons for preferring a phase-based treatment over a trauma-focused type of treatment.

keywords (complex) ptsd, emdr, evidence-based treatment, exposure, stabilisation, trauma-focused