Acceptance of a general practitioner-led narrative exposure intervention on post-traumatic stress symptoms after intensive care: a qualitative interview study with providers
In brief
GPs deem narrative exposure therapy for post-ICU PTSD feasible despite workload hurdles
In interviews with 15 general practitioners who delivered a brief narrative exposure intervention to patients with mild-to-moderate post-ICU PTSD, all found the approach doable but highlighted limited time, lack of psychotherapeutic experience, and the need for screening tools, training and supervision. Addressing these barriers could enable broader primary-care delivery of PTSD care.
- Journal
- BMJ open (Q1)
- Published
- 12 August 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Tomke Maria Schubert, Christoph Heintze, Jochen Gensichen, Antina Beutel, Cornelia Wäscher, Chris Maria Friemel, et al.
- PMID
- 42586728
- DOI
- 10.1136/bmjopen-2025-111473
Why clinicians should know about it
- Picked for Critical Care and Intensive Care Medicine (top studies of the week, 16 August 2026): Qualitative interview on GP‑led PTSD intervention after ICU
Abstract
BACKGROUND: Symptoms of post-traumatic stress disorder (PTSD) are prevalent in primary care (PC). Therapeutic needs are not always met. In the multicentred, randomised-controlled PTSD after Intensive Care Unit Survival (PICTURE) trial, patients with mild to moderate symptoms of PTSD following intensive care received a short-term intervention based on narrative exposure therapy (NET-PC) by their general practitioner (GP). OBJECTIVE: To explore the acceptance of NET-PC by participating GPs. DESIGN, SETTING AND PARTICIPANTS: We conducted semi-structured telephone interviews with GPs who had performed NET-PC within the PICTURE trial. The interview guide was based on the Theoretical Framework of Acceptance. The interviews were recorded, transcribed and analysed using qualitative content analysis. RESULTS: We analysed 15 telephone interviews averaging 51 min in length. The interviews revealed varying perceptions of the frequency and relevance of mild to moderate symptoms of PTSD. Those who saw it as relevant were ready to implement NET-PC despite its high organisational and time commitment. Challenges arose from GPs' lack of experience with psychotherapeutic interventions, including dealing with strong emotional reactions from patients, and from the difficulty of scheduling longer consultations into routine practice. Suggested support included validated screening tools, training opportunities and psychotherapeutic supervision. Furthermore, NET-PC should only be offered at the GPs' discretion. CONCLUSIONS: From the interviewees' perspective, NET-PC is feasible for use in general practice. The identified challenges could be addressed by enhanced training and supervision and adequate funding for consultations. A NET-based intervention may be feasible in general practice for patients suffering from mild to moderate symptoms of PTSD after intensive care. TRIAL REGISTRATION NUMBER: NCT03315390.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.