Importance of Trauma-Informed Care in Substance Use Disorder Recovery for Women

The high prevalence of trauma and post-traumatic stress disorder (PTSD) in individuals with substance use disorder (SUD) presents a number of challenges for community treatment providers and programs in the U.S.

Although several evidence-based, integrated therapies for the treatment of co-occurring PTSD and SUD have been developed, implementation of these practices in community treatment programs remains low.

This study examined common barriers preventing adoption of integrated treatments for PTSD/SUD among community treatment programs and providers, looking at organizational-, provider-, and patient-level factors. A variety of challenges were identified, including:

• Limited resources for providing the training and ongoing supervision required for effective implementation of a new treatment intervention
• High staff turnover
• Clinicians who only have certification in addiction and no affiliation with psychiatric services

• Concern about the timing of initiating trauma work
• Need for program-level advocates for the intervention to support and facilitate implementation
• Limited training in the field of co-occurring PTSD and SUD
• Lack of support from supervisors to help mitigate counselor exhaustion and turnover

• Lack of control over what therapy is delivered to them
• Lack of knowledge about what treatments are the most effective for their needs

Conclusions: Despite increasing awareness of the need to address co-occurring PTSD and SUD, numerous factors present challenges to the implementation of integrated therapies in front-line community substance use disorder treatment programs. Understanding and addressing these challenges may help facilitate increased use of evidence-based integrated treatments for PTSD/SUD at all levels of an organization.

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Funding for this Addiction Science Made Easy project is provided by the Addiction Technology Transfer Center National Office, under the cooperative agreement from the Center for Substance Abuse Treatment of SAMHSA.

Articles were written based on the following published research:

Citation: Killeen TK, et al. Implementation of integrated therapies for comorbid post-traumatic stress disorder and substance use disorders in community substance abuse treatment programs. Drug and Alcohol Review 2015 (in press).