Complex Post Traumatic Stress Disorder (C-PTSD) Consultation Service

Facts about Complex PTSD


What is Complex PTSD?
Complex PTSD (C-PTSD for short) is related to, but separate from PTSD. It describes a set of difficulties, which may result from exposure to particularly severe, often prolonged or multiple traumatic experiences in childhood or in adulthood. For example, repeated childhood sexual and physical abuse, torture, severe domestic violence, slavery and genocide. Some people who have survived such devastating experiences may go on to develop all the symptoms of PTSD and experience additional difficulties, which impact negatively on health and wellbeing in three additional areas.

• Problems in regulating mood
• A persistent sense of worthlessness, experiencing a powerful sense of shame, defeat or guilt related to what they have survived.
• Significant difficulties in sustaining relationships and in feeling close to others.


C-PTSD and Borderline Personality Disorder
Although C-PTSD can sometimes be confused with Borderline Personality Disorder, it is different in the problems it causes, the treatment it responds to and the likely benefit treatment may have. Some people who have experienced repeated, severe trauma may go on to develop both.


Who is most likely to develop C-PTSD?
C-PTSD is less common than PTSD and most likely to occur as a result of repeated childhood physical or sexual abuse, especially if this happens within the family.


Do people recover from C-PTSD?
Although standard treatments for PTSD can help alleviate symptoms for some people, treatment may need to be adapted. These adaptations vary depending on the exact nature of the difficulties. These treatments have been found to be helpful in a number of research studies.


Aims of treatment:
• To build a strong, collaborative therapeutic alliance to promote safety, trustworthiness and respect.
• To help manage symptoms that cause instability, dissociation and difficulties in relationships. To build healthy coping to reduce the negative effects that PTSD has on life. 
• To help process the trauma memories so that puts traumas more firmly in the past.
• To help deal with unhelpful ways of thinking and behaving in ways that will reduce persistent sense of worthlessness and strong emotions like guilt, shame and anger.
• To gradually plan activities to restart a fuller, less restricted life.


How can OHSPIC help?
• Assessment & advice
An expert assessment can be arranged on an outpatient or outreach basis. The assessment will usually take up to 3 hours plus additional liaison with relevant clinical care teams. The assessment will provide a comprehensive and shared understanding of the problem and associated difficulties to determine what NICE recommended therapeutic intervention would be indicated at this point in time. The findings will be summarised in detail and include specific recommendations.


• Organisational consultancy
We offer a range of services to support care teams in clinical decision making for patients with Complex PTSD presentations. These include formulation and consultation for clinical care teams,  ongoing clinical supervision of clinicians and training. 


Other resources:

Updated guideline on PTSD and its treatment (2018):




National Centre for PTSD: