Educational, but demanding: The experience of therapists in an intensive inpatient trauma treatment program

Veronica Vaage-KowalzikJeanette EngesetMarianne JakobsenJulie Evensen^*

• Oslo University Hospital, Oslo, Nordland, Norway

Background: Intensive trauma treatment programs have shown robust results in treating posttraumatic stress disorder (PTSD). However, the experiences of therapists working within the frameworks of these treatment programs have only scarcely been explored through quantitative studies and have not previously been examined in qualitative studies. Objective: This study aimed to explore therapists' experiences in an intensive trauma treatment program (ITTP). Our research questions were: How did the therapist experience working within the ITTP, and how did the treatment program influence them as trauma therapists? Methods: Seven therapists who had participated in a two-week intensive inpatient trauma treatment program involving Prolonged Exposure, Eye Movement Desensitization and Reprocessing, and therapist rotation (TR) were interviewed using a semi-structured qualitative interview format. The transcripts were analyzed using a thematic analysis approach. Results: Our analysis resulted in three main themes: 1) Learning through shared experiences, 2) A new experience of trauma therapy changing attitudes and praxis, and 3) Doubts about intensive trauma treatment. The therapists described the treatment project as demanding yet a valuable learning opportunity. Most expressed initial hesitations about providing trauma-focused therapy (TFT), fearing that patients might deteriorate, but participating in the project appeared to alter their attitudes and practices regarding TFT. TR was described as an excellent learning environment and a means to share the burden of responsibility. Our therapists noted that the program's intensity and multimodality contributed to its effectiveness, though some questioned whether the program was too intensive. Conclusions: Our findings highlight the uneasiness therapists face when performing TFT and emphasize the value of a supportive and educational atmosphere in delivering TFT. One approach to fostering such an environment is to implement TFT within an intensive treatment program with therapist rotation, allowing therapists to learn from and support one another while providing manualized TFT.