Interview: n=14

Focus group: n=2

Focus groups & interviews: n=2

Free-text written response: n=1

Nineteen studies (Bermudez 2013; Borman 2013; Dittman 2014; Eisenman 2008; Ellison 2012; Ghafoori 2014; Hundt 2015; Jindani & Khalsa 2015; Kaltman 2014; Murray 2016; Palmer 2004; Possemato 2015; Salloum 2015; Stankovic 2011; Story 2017; Taylor 2013; Valentine 2016; Vincent 2013; West 2017), reported experiencing apprehension engaging in the intervention or service.

Service users felt a sense of reluctance and experienced difficulties engaging with therapists (Dittman 2014; Eisenman 2008; Hundt 2015; Salloum 2015; Story 2017; Taylor 2013; Valentine 2016; Vincent 2013). However, authors noted how with supportive and engaged therapist’s service users were able to overcome their reservations and access or continue to access services.

Service users also expressed a reluctance to reflect on their traumatic experience and a further reluctance to continue to reflect on their experience (Borman 2013; Dittman 2014; Eisenman 2008; Ghafoori 2014; Hundt 2015; Jindani 2015; Palmer 2004; Salloum 2015; Stankovic 2011; Taylor 2013; Vincent 2013).

However, other service users felt this reflection was necessary and allowed for the process of recovery (Bermudez 2013; Hundt 2015; Jindani 2015; Murray 2016; Salloum 2015; West 2017). The authors recommended the need for individualised and tailored treatment.

Services users also described apprehension engaging in the intervention or service due to stigmatisation from service providers, family members or carers and society as a whole (Ghafoori 2014; Kaltman 2014; Palmer 2004; Possemato 2015; Valentine 2016; Vincent 2013). Some service users felt they were able to overcome stigmatisation.

Interview: n=14

Focus group: n=3

Focus group and interview: n=1

Eighteen studies (Dittman 2014; Eisenman 2008; Ellison 2012; Hundt 2015; Jindani & Khalsa 2015; Kaltman 2014; Niles 2016; Palmer 2004; Possemato 2015; Possemato 2017; Salloum 2015; Salloum 2016; Stankovic 2011; Taylor 2013; Tharp 2016; Valentine 2016; Vincent 2013; Whealin 2016), reported on the organisation of the intervention or service.

Service users expressed a lack of understanding and awareness of which treatment approaches would be appropriate and described a lack of suitable direction to services (Eisenman 2008; Ellison 2012; Whealin 2016).

Service users described the need for clear and structured interventions and services with set learning objectives (Hundt 2015; Jindani 2015; Niles 2016; Possemato 2015; Possemato 2017; Salloum 2015; Salloum 2016; Stankovic 2011).

Service users noted the importance of a flexible approach to interventions and services and some favoured interventions and services in non-clinical environments (Ellison 2012; Niles 2016; Possemato 2017; Valentine 2016; Whealin 2016).

Service users expressed the need for an option for the involvement of family members in their care (Dittman 2014; Hundt 2015; Kaltman 2014; Niles 2016; Palmer 2004; Possemato 2015; Salloum 2015; Salloum 2016; Taylor 2013; Tharp 2016). However, in a study (Dittman 2014) of children with PTSD some children described a reluctance for family involvement.

Service users described experiencing an abrupt end to treatment and the need for a substantial follow-up period (Niles 2016; Palmer 2004; Possemato 2015; Stankovic 2011; Tharp 2016; Vincent 2013).

Services users expressed the need for configuration of services during and after treatment, including providing consistent care across services and individualised care, such as the option for gender matched and bilingual doctors (Bance 2014; Ellison 2012; Hundt 2015; Kaltman 2014; Kehle-Forbes 2017; Palmer 2004; Stankovic 2011; Vincent 2013).

Interview: n=13

Focus group: n=2

Focus group & interview: n=3

Eighteen studies (Bermudez 2013; Borman 2013; Dittman 2014; Eisenman 2008; Ellis 2016; Ellison 2012; Hundt 2015; Jindani 2015; Kaltman 2014; Kaltman 2016; Niles 2016; Palmer 2004; Possemato 2015; Stankovic 2011; Story 2017; Tharp 2016; West 2017; Whealin 2016) described service-users sharing common experiences with peers.

Service users discussed the benefits of sharing their experience with others who have also experienced traumatic events (Bermudez 2013; Borman 2013; Dittman 2014; Ellis 2016; Ellison 2012; Jindani 2015; Kaltman 2014; Kaltman 2016; Niles 2016; Palmer 2004; Possemato 2015; Stankovic 2011; Story 2017; Tharp 2016; West 2017; Whealin 2016).

However, some service users expressed a reluctance to peer support interventions or services (Eisenman 2008; Ellison 2012; Palmer 2004; Tharp 2016).

Service users also described peer recommendations as a prompt into treatment (Ellison 2012; Hundt 2015).

Interview: n= 15

Focus group: n=2

Focus group and interview: n=2

Free-text written response: mn=1

Eighteen studies (Dittman 2014; Eisenman 2008; Ellison 2012; Hundt 2015; Kaltman 2014; Kaltman 2016; Murray 2016; Niles 2016; Palmer 2004; Possemato 2017; Salloum 2015; Salloum 2016; Stankovic 2011; Story 2017; Valentine 2016; Vincent 2013; West 2017; Whealin 2016) reported interventional support by trusted experts.

Service users expressed an avoidance of relational support in favour of receiving support from trusted experts (Dittman 2014; Eisenman 2008; Kaltman 2014; Salloum 2016; Valentine 2016).

Service users highlighted their trust in professionals to provide appropriate interventions and services (Dittman 2014; Ellison 2012; Hundt 2015; Kaltman 2014; Kaltman 2016; Murray 2016; Niles 2016; Palmer 2004; Possemato 2017; Salloum 2015; Stankovic 2011; Story 2017; Vincent 2013; West 2017; Whealin 2016).