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

May 1, 2015
Kileen, TK et al.
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).
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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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