A classic scene from adventure movies often features the main hero or heroine slashing through a thick wall of vines in a forest or jungle as they escape the villains. It’s an apt metaphor for what trauma and addiction can look like in a person’s life: impenetrable, insurmountable, and intractable. Among people with an addiction, it is believed that about half have experienced trauma. This is why Encore offers an addiction and trauma outpatient program
In fact, like those vines, trauma and addiction intertwine in a symbiotic relationship that can make treating them separately both difficult and unproductive. They share common symptoms, including hypervigilance, anxiety, social isolation and emotional numbing. The person with trauma seeks to avoid reminders of the traumatic incident while the person with substance use disorder often uses alcohol or drugs to avoid negative emotions or enhance positive ones. Similarly, a person who has experienced trauma may take drugs to maintain hypervigilance and keep them safe, though it often has the opposite effect.
Historically, most treatment providers advocated for treating the two sequentially rather than integrating treatment. There were a variety of beliefs regarding which should be treated first and why. Today, however, evidence shows that integrating treatment significantly reduces symptoms related to both as well as to co-occurring disorders like depression.
Assessment
The foundation of integrated treatment is assessment. As noted by SAMHSA, people with substance use disorder and PTSD are often not assessed for trauma and only treated for addiction. Treating the substance use disorder but not the trauma is unlikely to alleviate the trauma symptoms. The reverse, however is not true. If trauma symptoms are treated, it reduces the chances of heavy substance use.
Integrated Addiction and Trauma Outpatient Program Approach
Encore’s treatment approach is founded on effective, evidence-based, trauma-informed modalities and begins with a thorough assessment to determine if trauma as well as co-occurring disorders are present. By understanding a patient’s past traumatic experiences or those that may be ongoing, Encore’s clinical treatment team can formulate a trauma-informed treatment plan to treat both concurrently. Doing so ensures that treatment does not trigger the patient, causing them to react in ways that could lead to leaving treatment or self-harm. Our approach to trauma-informed care also includes cultural awareness so we can better understand the patient’s history and plan for treatment that will be the most effective.
Trauma-informed Care
Trauma-informed care is a patient-centric approach that specifically tailors treatment to the patient’s needs. Encore’s therapists take the time to get to know the patient, building trust and safety so that treatment has the best chance of success. The symptoms that are associated with both trauma and substance use disorder are often unhealthy coping skills that have helped the patient deal with trauma and helped to suppress emotions that feel overwhelming. With a baseline understanding of what the patient is dealing with in terms of substance use disorder and trauma, we can incorporate treatment modalities like cognitive behavioral therapy (CBT), a kind of therapy that helps patients to change their thinking patterns in order to better cope with addiction, trauma, and other issues, as well as modalities like EMDR, a psychotherapy that reduces symptoms and emotional distress that are the result of disturbing life experiences.
Encore’s assessment process and initial work with patients also helps us to determine if there is a need for medications. In cases of trauma and addiction, medications to relieve anxiety, depression, or other related issues can be helpful to enable the patient to participate in treatment.
Processing the Trauma
When we have contained the damaging effects of the trauma and addiction and given the patient ways to safely cope with their symptoms, we can begin to work with the patient to process the traumatic incident and alleviate their symptoms. The modalities we use to do that vary according to the needs of the patient. CBT and EMDR, as well as dialectical behavior therapy (DBT), are evidence-based, effective therapies that we commonly use in this phase of treatment. We also use modalities like breathwork, yoga, art therapy, and mindfulness-based stress reduction to provide relief for the patient while in treatment. Those are also often a part of our recommendations for patients’ recovery plans as coping skills that can be used long term to maintain recovery and emotional health.
Our goal at Encore is to help people free themselves from the seemingly impenetrable thicket that addiction and trauma cause and give them respite, healing, hope, and recovery.
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