• It becomes important to understand the meaning of the traumatic event to an individual and to address those meanings in the context of recovery.
• Good treatment-- changes the perception of what happened who is at fault (if anyone) what could have been done to prevent, what the experience means in the present o AKA – change our relationship with the traumatic experience o Child see their self as damaged goods, have a sense of shame o Adulthood – powerless, guilt, inadequacy o Events of nonhuman/large scale – spiritual crisis of faith, disruption of worldview, meaning/purpose loss
• Treatment o Late 1990’s push back on sequential treatment. Meaning addiction was treated primary then focus of other areas: trauma, mental health, family dynamics
Cons of sequential treatment
• Could not build stable foundation, control behavioral problems
• Patients in SUD treatment who are not equipped to manage their symptoms may experience worsening effects on their trauma as SA symptoms improve o Parallel treatment (multiple treatment programs)
Cons
• Fragmented care
• Patients are unable to navigate or make sense of different communication about treatment and recovery o Integrated treatment
Pro
• Facilities (providers) are cross trained. Counselors have a basic client education and working knowledge on trauma.
• Shared decision making by helper/client
• Range of service and assertiveness in outreach and client management
• Benefited in earlier interventions and prevented relapse.
Cognitive-Behavioral Therapies for Psychological Trauma and Comorbid Substance Use Disorders – Book Journal • Client suffering from co morbid PTSD and SUD might not only experience anxiety when he/she has a trauma-related intrusive thought, but he/she also experiences an urge or craving for alcohol
• Cognitive Behavioral Therapy o Addresses fear, avoidance strategies, learning contingencies and