How do clinicians work with the shift between stabilisation-work and exposure-work in PTSD-treatment? Interviewing clinicians - a grounded theory study
The objective with this doctorate thesis is to examine how clinicians work with the shift between the stabilisation-phase and the exposure-phase in PTSD-treatment. Specifically, the aim is to explore how clinicians conceptualise exposure-readiness and how they evaluate when clients are ready to initiate exposure-work. For this, semi-structured interviews with psychologist providing trauma-focused treatments in PTSD secondary care services within the NHS were conducted. Data was analysed using grounded theory, from which the core concept: “clinicians are managing their role and resources in relation to the treatment-model” emerged. This core concept was further expressed through interrelated components termed: 1. Clinicians view exposure-readiness to be determined by more than traditional stabilisation-work due to the psychological and social complexity of PTSD-clients. 2. Clinicians view that treatment needs to be more integrative as opposed to solely conducting trauma-therapies in order to meet clients’ complex needs. 3. Clinicians advocate that the concept of exposure-readiness needs to be re-evaluated to make treatment more effective. 4. Clinicians feel that the prescribed treatment-model pose challenges to providing effective treatment. These findings will be discussed in relation to literature, along with the theoretical conceptualisation this data gave rise to. Qualitative research on how clinicians are working with exposure-readiness and the shift between the treatment phases in PTSD-treatment is limited. Therefore, this study helps to crystallise these elusive clinical processes, and constitutes a valuable scientific contribution which can help improve PTSD-treatment.
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