For many who have an issue with substance use, there is something beneath the surface that hasn’t healed properly. The trauma that someone has experienced, either from childhood, past relationships, losses, or things that they cannot fully explain, has shaped how they navigate their life. At All In Solutions, our trauma-focused treatment is designed based on the understanding that to achieve lasting recovery, we must look at what a person is using as well as why they are using it.
What Is Trauma-Informed Care?
Trauma-informed care means providing health care and treatment for substance abuse in a manner that acknowledges the impact of trauma and reduces any additional trauma during the healing process.[1] Trauma-informed care is both a clinical framework and a cultural orientation that guides the development of all therapeutic modalities and the manner in which the provider interacts with clients throughout the continuum of care.
SAMHSA’s six guiding principles of trauma-informed care allow for service delivery from organizations that operate under this framework:
- Safety — Establishing physical and emotional safety for clients at all times
- Trustworthiness and Transparency — Creating trust through honest communication, consistency in the provision of services, and setting realistic expectations for clients
- Peer Support — Having people in recovery who have had similar experiences provide support to clients
- Collaboration and Mutual Respect — Viewing the relationship between the therapist and client as a partnership and not a hierarchy
- Empowerment, Voice and Choice — Including the client in every step of the treatment process and allowing the client to feel empowered through their strengths
- Cultural, Historical, and Gender Issues — Recognizing how identity, cultural background, and life experiences all influence how a person is impacted by trauma and what their specific needs are as a result
A trauma-informed approach does not mean that every session must address a traumatic experience. It does mean that every area of the treatment experience, from intake through discharge, has components based on the recognition of the impact of trauma on a person’s behavior, their relationships, and their ability to engage in the treatment process.
How Trauma-Focused Therapy Works
Trauma-Informed vs. Trauma-Focused Treatment
A trauma-informed approach is the overall framework for the delivery of care. A trauma-focused approach refers to the evidence-based methodologies that target the processing and resolution of trauma through specific therapies. At All In Solutions, we offer both trauma-informed care and trauma-focused therapies to our clients, depending on whether their trauma history is a factor in their substance use.
At All In Solutions, we offer both. Our entire treatment environment is trauma-informed, and for clients whose trauma history is directly driving their substance use, we incorporate trauma-focused therapies into their individualized treatment plan.
Evidence-Based Trauma Therapies
All clients receiving trauma-focused treatment can expect one or more of the following services:
- Eye Movement Desensitization and Reprocessing (EMDR) EMDR is one of the most widely researched and utilized trauma-focused therapies today. EMDR was developed to treat those with PTSD, but has since been found to be effective in treating a variety of trauma-related issues. This therapy works by stimulating the brain’s ability to process and reprocess traumatic events by utilizing bilateral stimulation (most commonly through the use of eye movements ) as a means of aiding the reprocessing of the traumatic memory and reducing the emotional charge of that memory.
- Cognitive Behavioral Therapy (CBT) CBT helps clients identify the relationship between their past experiences, distorted thoughts, and self-destructive behaviors, including addiction. By working to reframe distorted thought processes and develop healthy coping mechanisms, CBT is a method of addressing trauma and addiction simultaneously. CBT has more evidence supporting its efficacy than any other modality for both of these conditions.[5]
- Dialectical Behavior Therapy (DBT) DBT was originally created to provide treatment for individuals with severe emotional dysregulation related to trauma. Because DBT teaches clients to tolerate distress, manage their emotions, and develop effective interpersonal skills, it is a beneficial therapy for those whose trauma history has resulted in difficulty managing intense emotions, a common risk factor for addiction.
How Does Trauma Release Happen?
One of the most frequently asked questions regarding trauma therapy is: How exactly do we heal from trauma?
The answer may vary person to person, depending on which therapeutic method is used, but the majority of effective trauma treatment approaches share some common components.
Trauma is stored in our bodies as well as our memories. Many trauma survivors display physical symptoms like tension, hypervigilance, and feeling unsafe, which are associated with the nervous system’s processing of their trauma. The goal of effective trauma-focused therapy is to help people complete what their nervous system was unable to and process the trauma. In order to do this, we must complete the stress response cycle and move beyond our current activated state to achieve true resolution.
This is done through cognitive processing (making sense of the experience) and somatic resolution, which involves acknowledging and gradually releasing the physical manifestations. almost always through bilateral or whole-brain processing. EMDR, in particular, is understood to work in part by facilitating this kind of bilateral, whole-brain processing.
The Connection Between Trauma and Addiction
The relationship between trauma and substance use disorder has been well documented through behavioral health research. People who have suffered trauma are far more likely to develop a substance use disorder, while those who have developed a substance use disorder are far more likely to have experienced trauma than the general population.[2]
This is no coincidence. When someone experiences trauma, it changes their brain chemistry and impacts their ability to cope with daily living.[3] When an individual is exposed to traumatic events, they experience changes in their hormonal system and brain function, which affect their ability to manage emotions, as well as increase their likelihood of developing post-traumatic stress disorder (PTSD), which makes it very difficult for them to function on a day-to-day basis. In all too many cases, a person ultimately begins to use substances in order to manage their pain, reduce hyper-vigilance, or even to fall asleep at night. But what starts as an act of self-medication can quickly develop into a dependence and lead to a self-perpetuating cycle of trauma and addiction.
According to SAMHSA, trauma is a public health epidemic, and the vast majority of those who seek treatment for substance use disorder have a history of trauma.[4] There is a direct correlation between childhood trauma, which includes abuse, neglect, and household dysfunction, and an individual’s likelihood of developing a substance use disorder, mental health disorder, and poor outcomes as an adult.[5]
Examining trauma as a part of substance use treatment is not an option; it’s a requirement, or the underlying dynamics of the substance use problems stay present and increase the likelihood of relapse.[6]
The Efficacy of Trauma-Focused Treatment for Addiction
Research continues to support the efficacy of trauma-informed and trauma-focused methodologies for treating substance use disorders. Through integrated treatment approaches that recognize both the trauma and its relationship to the substance use disorder, clients have been found to have improved treatment outcomes across the board.
Studies find that PTSD symptoms and substance use significantly decreased following the use of trauma-focused interventions among those with co-occurring disorders.[7] Research has also shown that EMDR is successful not only in reducing PTSD symptoms but also in reducing cravings and improving emotional regulation in people with a substance use disorder.[8]
SAMHSA national data demonstrates that people seeking treatment for substance use disorders have high rates of trauma — particularly childhood trauma —which is strongly associated with developing an addiction.[9] To address the entire person and not just their addiction, it is imperative to implement trauma treatment when working with those who have both substance use disorders and trauma-related issues.
Most importantly, research has shown that clients who are re-traumatized during substance use disorder treatment are more likely to drop out of treatment, relapse, and disengage from care.[10] By implementing a true trauma-informed approach, the treatment environment becomes a safe place for clients to make the necessary advancements towards their recovery.
What to Expect From Trauma-Focused Treatment
When a client begins trauma-focused treatment, they will not have to immediately face or relive their most painful memories. Trauma therapy is completed at a pace that is based on the client’s readiness, desire, and sense of safety.
Most facilities will complete a thorough assessment of each client’s history of trauma, mental health disorders, and substance use prior to commencing trauma-focused services, so that a treatment plan can be developed with a specific level of care and an appropriate pace for engaging in trauma therapy.
Trauma-focused treatment happens through both individual sessions and group therapy, providing support and connection with others who have shared similar experiences. For many, the experience of listening to others who have experienced similar trauma will facilitate the healing process.
While completing trauma-focused therapies, clinicians monitor for any signs of the client becoming overwhelmed, and are trained to modify the intensity of the trauma therapy being provided. The goal is not to accelerate through processing traumatic memories as quickly as possible, but rather to create an environment within which true and lasting healing can occur.
Trauma-Focused Treatment at All In Solutions
At All In Solutions, we have a firm belief that true recovery must address the root cause of addiction. Our trauma-focused treatment team uses evidence-based trauma therapy methods and provides treatment in a trauma-informed care setting. We work to help our clients in finding better solutions to their problems, rather than using substances as an escape.
Whether you are looking for residential rehabilitation services for trauma and substance use, or trauma-specific services provided as part of an outpatient rehabilitation program, the All In Solutions team will work with you to develop and implement a treatment plan that gives you the support needed to reach your goals.
