Navigating usage of complex PTSD in adult mental health services: a scoping review on clinicians’ perspectives

Objective: Complex PTSD (C-PTSD) is a newly defined diagnosis in the International Classification of Diseases, necessitating research into how clinicians are adapting to its use. This scoping review aimed to examine qualitative literature on clinicians' experiences with the C-PTSD diagnosis in adult mental health services since 2018. Method: A comprehensive search from 2018 to March 9, 2024, was conducted across seven databases (MEDLINE, PubMed, Scopus, APA PsycArticles, APA PsycInfo, CINAHL, and ProQuest) using the population-concept-context framework for scoping reviews. The focus was on clinicians working with C-PTSD in adult mental health services, targeting qualitative data since 2018. Results: A total of 890 articles were identified, of which 11 met the inclusion criteria. Included studies were conducted across diverse settings, including private practice, public health, and trauma-specific services, involving a total of 303 participants. Where gender was reported, most participants were female (74.6%). Four key areas were identified from studies on clinicians adapting to C-PTSD in clinical practice: (a) understanding C-PTSD as a diagnosis, (b) the challenge of the therapeutic relationship and person-centered C-PTSD treatment, (c) barriers to C-PTSD treatment, and (d) impact of C-PTSD work on clinicians and organizational support. Conclusions: Despite significant advancements in understanding C-PTSD, clinicians often struggle with awareness and detection. This scoping review underscores the need for tailored training and resources to support clinicians in effectively managing C-PTSD. As recognition of this condition evolves in clinical and research settings, both clinicians and mental health services must adapt policies and practices to address the distinct needs of individuals with C-PTSD. Clinical Impact Statement This review highlights the challenges clinicians face with the complex posttraumatic stress disorder (C-PTSD) diagnosis in adult mental health care. Despite progress in understanding C-PTSD in research and diagnostic frameworks, clinicians appear to be struggling with awareness, detection, and treatment of the condition. The review emphasizes the need for specialized training and resources to help clinicians provide better care. To improve treatment outcomes, policymakers and clinical leaders should focus on creating tailored training programs and support systems for clinicians working with C-PTSD.