Combined individual and group-based stabilization and skill-training intervention: A thematic analysis of patients’ experiences

While many trauma survivors recover, up to half of the population seeking mental health care are estimated to present with a clinical picture in line with complex PTSD (C-PTSD). As the disorder of C-PTSD is new, there is insufficient data to guide recommendations for treatment. However, to address problems related to symptoms of disturbances in self-organization, a group setting may be useful. The aim of this qualitative study was therefore to explore how outpatients with long-term posttraumatic reactions experienced their participation in a combined trauma treatment, which integrated group-based stabilization and skill training (SST) alongside individual treatment as usual (TAU). Semi-structured interviews were conducted with five women with long-term posttraumatic reactions who had completed the combined trauma treatment. Transcripts were analyzed using reflexive thematic analysis. Participants identified three key aspects of the combined treatment format that were essential for their process of recovery. First, cohesive relationships between group members and between patients and therapists gave the participants new interpersonal experiences which helped them to alleviate stigma, improve negative self-perceptions, reduce social isolation, as well as exposed them to their challenges in forming and maintain relationships. Second, skill training was perceived as challenging but helped the participants to find new ways to understand and relate to their trauma symptoms. Third, individual treatment complemented group-SST by allowing for tailored adjustments and extended support. The participants’ descriptions support the perceived utility value of a combined stabilizing treatment approach for individuals with long-standing posttraumatic reactions. However, randomized controlled trials are needed to rigorously assess its short- and long-term effects.