This resource describes the aspects of critical care which can lead to the development of PTSD.
Offers theory, guidance, and prompts for mental health professionals. Downloads are in Fillable PDF format where appropriate.
Includes client-friendly guidance. Downloads are in Fillable PDF format where appropriate.
An editable Microsoft PowerPoint version of the resource.
Post-traumatic stress disorder (PTSD) can develop after intensive medical interventions. This resource describes the unique aspects of critical care that may contribute to PTSD, including invasive procedures, prolonged treatment, and the impact of sedation and delirium. Understanding these factors can enhance clinical engagement and outcome for survivors navigating post-discharge recovery.
Clinicians working with PTSD patients post-critical care can greatly benefit from understanding the distinct experiences that influence PTSD development in this context.
After exposure to life-threatening medical interventions in critical care.
Arising from fears related to medical treatment.
Use the handout to provide clients with a clearer understanding of their experiences.
Foster discussions to explore clients' beliefs and appraisals.
Facilitate memory reprocessing using the structured timelines of patient experiences.
Encourage exploration of sensory and body memories for comprehensive trauma work.
Utilize site visits or records access to help clients contextualize ICU experiences.
Post-traumatic stress disorder (PTSD) following critical care is a significant clinical issue. Patients in intensive care often undergo invasive procedures, experience profound disorientation, and may be subjected to prolonged sedation and isolation. These factors can lead to altered states of consciousness, fragmented memory encoding, and intense feelings of powerlessness — all of which heighten vulnerability to trauma responses. Research suggests that around 1 in 5 survivors of intensive care go on to develop PTSD, which is substantially higher than the general population incidence (Kilpatrick et al., 2013; Murray et al., 2020).
From a cognitive-behavioural perspective, PTSD following critical illness can be understood as arising from disrupted processing of traumatic experiences. Memories encoded during critical care often include hallucinations, delusions, or somatic sensations that result from delirium or sedation. These experiences may persist post-discharge as intrusive, trauma-like memories. The cognitive model proposed by Ehlers and Clark (2000) emphasises that PTSD develops when individuals interpret the trauma and its aftermath in a way that creates a continuing sense of threat—beliefs such as “I’m going mad” or “I’m permanently changed” are common in this context.
Therapy should focus on helping patients reprocess these memories and revise maladaptive beliefs. ICU memories are often fragmented or confused, and they may blend factual events with hallucinated content. Constructing a narrative using memory recall, medical records, and critical care diaries can help patients make sense of their experience (Murray et al., 2020). Exposure techniques are useful not only for visual memories but also for somatic ones—such as discomfort linked to intubation or catheterisation — that may function like traditional flashbacks. Sensory triggers (e.g., beeping monitors, body positions) should also be addressed in therapy.
Clinicians should also be prepared to work with mistrust or paranoia linked to ICU experiences. For example, patients may develop suspicious beliefs about healthcare staff due to interactions while delirious. These responses are not psychotic symptoms but post-trauma interpretations shaped by delirium and fear (Griffiths & Jones, 1999; Jackson et al., 2007). Psychoeducation about the effects of critical illness and the normalising of hallucinations and cognitive disruption during ICU stays can be powerful tools in helping clients reappraise and recover.
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