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Challenges of Implementing a Trauma Intervention into a Clinical Treatment Program.

Counselor 2010;11(5):56-61

Chanda Brown, PhD (Charleston Center, SC Node), Therese Killeen, PhD, APRN-BC (Medical University of South Carolina, SC Node), Louise F. Haynes, MSW (Lexington/Richland Alcohol and Drug Abuse Council, SC Node).

Many women entering substance abuse treatment have been exposed to traumatic experiences, such as childhood physical or sexual abuse, interpersonal violence as an adult, including domestic violence and assault, and sexual assault or rape. Research suggests that up to 80% of women entering substance abuse treatment have experienced traumatic events in the form of physical or sexual abuse. Alcohol and substance abuse increase the risk of developing post-traumatic stress disorder (PTSD) after exposure to a trauma, a debilitating anxiety disorder which includes symptoms of avoidance, sleep disruption, flashbacks, nightmares, impaired concentration, and exaggerated startle response. These symptoms can interfere with substance abuse treatment and studies have shown that substance abusing individuals with untreated PTSD have poorer outcomes than those without PTSD. The National Drug Abuse Treatment Clinical Trials Network (CTN) implemented a multi-site research study to explore the feasibility and effectiveness of implementing a trauma-focused intervention, Seeking Safety (SS), for women with comorbid PTSD and substance use disorder (SUD) enrolled in community substance abuse treatment programs. This article describes the study (protocol CTN-0015) and the Seeking Safety intervention, as well as the challenges faced by staff and patients in the implementation of the new integrated treatment intervention. Though the Seeking Safety intervention did not prove more effective in treating substance use disorder than the control intervention (Womens' Health Education), it did result in significant impromvements in patients' PTSD symptoms. It also increased knowledge and awareness of comorbid trauma and SUD. Successful adoption of interventions like Seeking Safety provide a good example of agencies that are competently moving forward in the dissemination of new treatment modalities. (Magazine article, PDF, English, 2010)

Keywords: Adoption of interventions | Attitudes of health personnel | Co-occuring disorders | Counselors | Gender-specific interventions | Post-traumatic stress disorder (PTSD) | Seeking Safety program | Training | Trauma | Women | Women's Health Education program | Counselor (magazine)

Document No: 542

Submitted by Louise Haynes, SC Node, 11/7/2010.

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Supported by a grant from the National Institute on Drug Abuse to the University of Washington Alcohol and Drug Abuse Institute.
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