Trauma-informed care is a type of approach in the field of human services that assumes a person is likely to have undergone traumatic experiences. Trauma-informed drug rehab and treatment recognizes the role trauma may have in a specific individual’s substance misuse.
Trauma-informed rehab is a systemic approach that not only looks into specific treatments but also the way substance use disorder (SUD) is framed. This approach is now growing in popularity among rehab programs here in Dallas.
In Using Trauma Theory to Design Service Systems. New Directions for Mental Health Services (2001) by Harris & Fallot, trauma-informed care changes the fundamental question from “What is wrong with this person?” to “What has happened to this person?”.
However, the point of trauma-informed rehab is not necessarily to treat trauma, PTS, PTSD alongside the SUD. Rather, the idea is for clinicians and staff to be aware of the role trauma plays in one’s condition, adjusting SUD treatment as necessary to account for it. The main goal is to avoid exacerbating a patient’s condition by “re-traumatizing” them through a less-considerate approach.
Today, it’s understood that substance use disorder and trauma are closely linked. In several studies, it’s been found that people with post-traumatic stress (PTS) and post-traumatic stress disorder (PTSD) are far more likely than the general population to also have SUD. Likewise, people with SUD are also likely to have traumas linked to their drug use.
Because of the high likelihood of SUD and trauma co-existing, many drug and alcohol rehab centers are beginning to shift to a trauma-informed care model. With such an approach, treatment can be done in a non-judgmental way that is more likely to benefit patients in the program that do have trauma.
While we are certain a link between trauma and SUD exists, the reason for the extremely high co-occurrence of trauma and substance misuse is still highly debated and is a subject of active research.
In the United States, four hypotheses explaining the SUD-trauma connection are currently popular among treatment professionals. They are as follows:
1.) Susceptibility hypothesis
This hypothesis states that some individuals who use drugs or drink alcohol are more susceptible to developing trauma compared to non-drug users and non-drinkers. While one of the first hypotheses on this subject, its popularity has waned as few studies support it.
2.) High-risk hypothesis
This hypothesis identifies drug and alcohol use as the cause of trauma, through the lifestyles typical of people who misuse these substances. As with the susceptibility hypothesis, few experts continue to support this idea.
3.) Self-medication hypothesis
This hypothesis could be considered ancient and predates the disease model of mental illness. This hypothesis states that people with trauma take drugs and alcohol to forget the trauma or to numb themselves from it. This hypothesis has a fair number of studies support it.
4.) Shared vulnerability hypothesis
This hypothesis says that conditions like PTSD and SUD share the same environmental and genetic risk factors, explaining their high comorbidity. There is a growing body of evidence supporting this idea, thanks partly to advances in genetic research made in the past few decades.
A few SUD and dual diagnosis treatments are associated with trauma-informed care. Note that these methods are also sometimes used at programs and facilities that do not use a trauma-informed care model.
1.) Eye Movement Desensitization and Reprocessing (EMDR)
This is a somewhat new type of psychotherapy designed for treating PTSD but which has now been adapted to treat SUD, anxiety, and other mental health issues. In EMDR, the therapist will ask a patient to track their fingers or another object with their eyes. Then they will be asked to recall traumatic events, including physical and emotional reactions. Later, the therapist will help the patient think of more pleasant thoughts. Over time, these sessions can have the effect of lessening the power of the trauma.
2.) Dialectical Behavior Therapy
This is a type of cognitive-behavioral therapy that tries to improve a patient’s emotional resilience and tolerance through mindfulness and mediation techniques. When the patient’s emotional stability is improved, the therapist can then begin helping them reframe their problems and traumas more constructively.
3.) Exposure Therapy
Originally developed for anxiety, exposure therapy has also been used successfully for treating trauma related to substance misuse as well. The premise is to introduce things that make a patient anxious or fearful gradually, allowing them to get used to things that they previously felt were unacceptable.
4.) Seeking Safety
This is a fairly new evidence-based approach to treating trauma. It emphasizes building coping skills, education, and grounding techniques that help the patient get a better grasp of reality.
It certainly couldn’t hurt in most cases. With our improved understanding of the links between trauma and SUD, trauma-informed care approaches are fast becoming a mainstream part of drug and alcohol rehab.
For a listing of drug rehab centers in Dallas that offer a trauma-informed approach, please get in touch with our team at Dallas Drug Treatment Centers. Good luck, and be well!