Therapy should be offered to patients within a month of a traumatic event to help prevent post-traumatic stress disorder (PTSD), according to draft guidance, with a new focus on early treatment.
The National Institute for Health and Care Excellence is updating its guidance on the management of PTSD for the first time since the original was published in 2005.
“We have updated our guidance to make sure that PTSD is managed as early as possible”
Its draft update has recommended that patients who experience traumatic events and present symptoms of PTSD should be offered trauma-focused therapy within one month.
Adults who are at risk of PTSD should be referred for individualised cognitive-behavioural therapy within a month of experiencing a traumatic event, the draft said.
As well as the option of individual therapy, it said children could also be considered for group therapy after shared trauma to reduce the risk of developing PTSD.
In addition, if trauma-focused therapy was unsuccessful, children aged seven to 17 years could be offered eye movement desensitisation and reprocessing (EMDR) therapy after three months.
However, it said psychological debriefing, which aims to help a person find meaning after a stressful event, should not be offered to adults or children, as it was potentially harmful.
The new recommendation to offer therapy within a month, if finalised after consultation, would replace a “watch and wait” approach for mild PTSD symptoms in the original 2005 guideline.
It states that, where symptoms are mild and have been present for less than four weeks after the trauma, watchful waiting should be considered, with a follow-up contact within one month.
But trauma-focused cognitive behavioural therapy should be offered to those with severe post-traumatic symptoms or with severe PTSD in the first month after the traumatic event, it says.
Professor Mark Baker, director for the centre of guidelines at NICE, said: “PTSD is a treatable condition but the pain of revisiting past events can prevent people seeking the help they need.
“We have updated our guidance to make sure that PTSD is managed as early as possible and give advice on co-ordinating the complex needs that are often associated with this condition,” he said.
The new recommendations ask practitioners to take into account that people with PTSD may have additional problems such as depression and symptoms may present themselves in unusual ways.
In most cases where a person has both PTSD and depression, treating PTSD successfully will, as a consequence, improve the depression, said the draft guidance.
However, it noted that PTSD suffers may struggle to engage in therapy. NICE suggested that alternative methods of communication should be considered for example, text messages and video.
The guidelines authors also acknowledged that a range of situations that could be related to PTSD, including gender reassignment, homelessness and illegal immigration.
The draft recommendations will be available for consultation until the 23 July, with final guidance expected to be published in December.