Online Program

Building a trauma-informed system of care within treatment for alcohol, tobacco and other drug disorders

Tuesday, November 5, 2013

Norma Finkelstein, PhD, Institute for Health and Recovery, Cambridge, MA
Laurie Markoff, Ph.D., Institute for Health and Recovery, Cambridge, MA
Research indicates that the vast majority of individuals with substance use disorders (SUDs) have experiences of victimization, and that incorporating an understanding of the impact of trauma into treatment improves outcomes. The Massachusetts Department of Public Health/Bureau of Substance Abuse Services (BSAS) contracts with the Institute for Health and Recovery (IHR) to apply principles of organizational change to enhance the ability of the treatment system to provide trauma-informed care. Initially, training was provided for staff, but one lesson learned was that training alone did not lead to practice change. IHR then began working with individual SUD programs to conduct needs assessments, train staff, create trauma integration teams, and develop and implement trauma integration strategic plans. While this strategy was effective (as measured by change scores on self-assessments), it affected a small number of programs. To impact a larger number of programs, IHR is now training groups of programs at the same level of care and convening learning communities that meet by teleconference to develop and implement trauma integration strategic plans. IHR also assists with implementation of trauma-specific groups for adults (Seeking Safety, Helping Men Recover) and for children of parents in residential SUD treatment (Child Parent Psychotherapy) along with child-focused trauma consultation. IHR is using similar strategies in a women's prison and in a re-entry program in a county jail. It is recommended that agencies that wish to implement trauma informed care use a collaborative and flexible approach, but build on strategies with demonstrated effectiveness.

Learning Areas:

Administration, management, leadership
Advocacy for health and health education
Chronic disease management and prevention
Program planning
Provision of health care to the public
Social and behavioral sciences

Learning Objectives:
Discuss effective strategies for integrating an understanding of trauma into treatment for substance use disorders

Keyword(s): Family Violence, Substance Abuse Treatment

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: my work has focused on substance abuse prevention and treatment, with specific emphasis on women, children and families; pregnancy and substance use/abuse; integrated care for women with substance abuse, mental illness and histories of violence; trauma informed services; and family centered care. My work in the areas of policy, planning and research has resulted in over 50 professional publications. I have served as a reviewer of scientific publications and as consultant to numerous federal agencies.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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