Barriers to delivering trauma-focused interventions for people with psychosis and post-traumatic stress disorder: A qualitative study of health care professionals’ views

Abstract

Objectives: Trauma-focused interventions have been shown to be effective treatments for post-traumatic stress disorder (PTSD), and clinical guidelines support their use with people with psychosis. Despite this, they are used relatively infrequently in this population. We sought to explore UK health care professionals’ perceptions of what impedes or facilitates the use of trauma-focused interventions among people with psychosis and PTSD. Design: A qualitative study using constructivist grounded theory methodology. Methods: We conducted semi-structured interviews with 18 health care professionals working within the commissioning and delivery of clinical services for people with psychosis. Results: Three inter-related barriers to the use of trauma-focused interventions were conceptualized: coherent understanding; structural support; and safe space. Conclusions: Delivery of trauma-focused interventions within routine clinical practice may be supported by attention to the coherent integration of discussion of trauma into the clinical discourse of services; the processes, pathways, and organizational culture that facilitate access to treatment; and training that targets clinician confidence and skills.