Practice patterns for treating posttraumatic stress disorder in an out-patient setting in Germany

Background/Objectives: In the past years, several guidelines for the treatment of posttraumatic stress disorder (PTSD) have been presented, e.g. by the International Society for Traumatic Stress Studies (ISTSS) in the United States, by the National Institute for Health and Clinical Excellence (NICE) in the UK, and by the Association of Scientific Medical Societies (AWMF) in Germany. However, studies from the USA showed that evidence-based and recommended interventions such as exposure therapy are not as often used as expected. Until now it is not known, however, how far outpatient treatment of PTSD in Germany is based on these guidelines, and which factors of influence lead German therapists to decide against the implementation of exposure therapy in the treatment of PTSD. Our aim is to find out which treatment approaches are used in practice in Germany and which barriers prevent a more extensive implementation of evidence-based interventions.

Methods: In this study, we are investigating therapists treating patients with PTSD in an outpatient setting in two different German Federal States (Saxony and Hesse) using a questionnaire in a paper and pencil and an online version. We ask therapists about experiences in treating patients with PTSD in an out-patient setting, qualifications, and use of various interventions with patients with PTSD as a function of the type of traumatisation (complex, e.g. multiple childhood sexual abuse vs. non-complex, e.g. car accident). One focus is on the concept of ‘stabilisation’ as mentioned in the German AWMF guidelines.

Results: We will point out which interventions are used to in the outpatient treatment of PTSD in Germany and whether these are considerate of the type of traumatisation. Moreover, we will identify the main predictors for using interventions other than the evidence-based exposure therapy and its most frequently noticed contraindications.

Discussion/Conclusions: The current practice of treatment of PTSD in Germany will be compared to that in other countries, e.g. the USA and the Netherlands, as well as with treatment guidelines, especially those by AWMF. Starting points for an optimisation of the daily practice routine in treating patients with PTSD in German outpatient settings will be outlined.

Funding: Postgraduate scholarship of Free State of Saxony.

Keywords: Treatment guidelines, post-traumatic stress disorder, treatment.