The changing face of PTSD

Over the past decade, our understanding and treatment of post-traumatic stress disorder (PTSD) has evolved significantly. To mark PTSD Awareness Day (27 June 2025), our Clinical Director Dr Naomi Wilson shares four key developments we have incorporated into our specialist treatment for veterans.

Embracing trauma informed services

Trauma informed care increases awareness of how trauma can negatively impact on individuals and communities, particularly their ability to feel safe or form lasting relationships, that can include those with healthcare services and their staff.

At Combat Stress, we train all our staff (both clinical and non-clinical) to enable them to consistently respond to veterans who have experienced trauma in a way that prevents further harm and supports their recovery. We want to prevent retraumatisation by ensuring every interaction a veteran has with us enables them to feel safe and confident in the service we provide. All staff work to the principles of safety, trustworthiness, choice, collaboration, empowerment and sensitivity to the culture and needs of the veteran community. Our intention is to provide experiences that contrast with that of trauma.

Understanding and treatment of Complex-PTSD

Our understanding of the enduring impact of trauma is becoming increasingly sophisticated and in 2019 a new diagnosis of Complex PTSD (C-PTSD) was incorporated in the World Health Organisation International Classification of Diseases.

One of the main differences between PTSD and C-PTSD is our understanding of the causes of each. Typically, PTSD might be caused by a specific event or events while C-PTSD is caused by prolonged or repeated trauma over a significant period where escape may be very difficult or impossible. C-PTSD can be understood as PTSD with three additional groups of symptoms that cause extra distress - negative sense of self, relationships with others and severe emotional difficulties.

Following the introduction of this diagnosis, our research team, in collaboration with other international experts in the field, have rapidly become leaders in C-PTSD research. Studies exploring how common C-PTSD is in those veterans asking for mental health treatment and new treatments for C-PTSD are some of the first in the world. These treatments will help not only the military community but other populations with C-PTSD and are actively informing what services we deliver veterans and how we introduce innovation in care for those with C-PTSD.

Delivering personalised care

Every veteran who seeks our help has a unique life history, both positive and traumatic, and every veteran’s life circumstances now are unique. We recognise how important it is that veterans can receive not only effective, evidence-based treatment for PTSD or C-PTSD but that this is tailored to their individual needs.

We meet with veterans to assess their mental health difficulties in the specific context of their life now; understanding their strengths and capabilities and seek to understand what they want to be different and what recovery means for them. We use this information to talk to each veteran about the treatments most likely to work for them and help them think about the choices available to them also based on what they might prefer. Whilst all evidence-based psychological therapy for PTSD involves revisiting the traumas causing such difficulty now, personalised care means we ensure we can talk through treatment options and also how we plan treatment for each veteran session by session; some veterans prefer therapy which involves talking in depth through a few highly impactful traumas, others might prefer a therapy that involves talking through traumas across their life and creating a personal narrative, whilst others might prefer a focus that doesn’t necessarily require verbally recounting what happened to them.

This personalised evidence-based care within our specialist work ensures the treatment we provide is not only life-changing but very often life-saving. On average 70% of veterans who undertake our treatment recover, meaning they no longer meet the clinical criteria for a PTSD or C-PTSD diagnosis. This is an incredible impact, and one of which we are extremely proud.

Data driven care that improves outcomes

We continuously monitor and evaluate the impact of our treatments for PTSD and C-PTSD for those veterans who seek our help to ensure they’re working as effectively as possible. By giving greater access to the information veterans provide us, we seek to empower them to work collaboratively with clinicians to ensure that the care they are receiving is working as well as possible. Collecting and using clinical data in this way helps us refine our care, support excellence in clinical practice, and deliver better outcomes for veterans.

Collecting clinical data not only enables us to work collaboratively with veterans to plan and track treatment progress, but at a population level allows us to share insights with the veteran healthcare sector, inform clinical strategy and provide vital information for research contributing to the wellbeing of veterans well beyond the reach of our clinical service.

Together these advances reflect our unwavering commitment to delivering world-class compassionate care that evolves alongside our understanding of trauma and recovery from PTSD.