March On Stress

New NICE guidelines on post-traumatic stress disorder

Added on the 11th December 2018

New guidelines on post-traumatic stress disorder (PTSD) have been published by NICE – the National Institute for Health and Care Excellence.

The guidelines – published in December 2018 – are an update to the previous recommendations published in 2005.

The updated guidelines continue to recognise that there is no evidence to support the use of psychologically focused interventions immediately after a traumatic incident. Instead ‘watchful waiting’, now known as ‘active monitoring’, remains the recommended advice for how to deal with the majority of distress reactions that people exposed to trauma may experience.

The guidance also focuses on the needs of people who experience clinically important PTSD symptoms as well as those who formally suffer from PTSD.

March on Stress Director, and Professor of Defence Mental Health at King’s College London, Professor Neil Greenberg, was one of the experts on the guidance development committee. He explained: “Active monitoring, formerly known as watchful waiting, very much remains a key element of recommended practice. Proactive checking on whether people with less severe trauma symptoms will need further intervention is very much supported by the available evidence.”

The updated guidance also makes it very clear that psychologically focused debriefing for the prevention or treatment of PTSD is to be avoided.

The guidance states that ‘evidence on psychologically-focused debriefing, either individually or in groups, showed no benefit for children or adults, and some suggestion of worse outcomes than having no treatment.’ However, there are now a number of good evidence based therapies available to help those who need professional care.

The full guidelines, including the rationale and impact of the updates made, are available on the NICE website here.

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