A person suffering from PTSD and a substance use disorder can be complicated to treat.

Topic 5 DQ#1: Description

A person suffering from PTSD and a substance use disorder can be complicated to treat. As they abstain from substances, their trauma related symptoms may increase. How would you go about treating this person?

Re: Topic 5 DQ 1

Berenz and Coffey (2012) detailed how individuals with PTSD and substance use disorder often experience depression, attention deficit disorder, chronic pain, chronic illness such as liver disease, high blood pressure, and diabetes. I personally would utilize integrated treatment for the individual to ensure coordination of care is in place. Integrating care allows the client to receive the treatment needed with a team of professionals providing care in the same location. Integrated Care is essential for the individual receiving services in one location due to many may be more adept to services. It would be beneficial for the client that has exacerbated symptoms to seek individual psychotherapy, motivational interviewing techniques such as elicit/ evoke change talk, individual counseling sessions, family counseling if needed, psychopharmacological treatment and 12 step support groups.

Berenz, E. C., & Coffey, S. F. (2012). Treatment of co-occurring posttraumatic stress disorder and substance use disorders. Current psychiatry reports, 14(5), 469-77.

My response:

Good afternoon Stefanie

Re: Topic 5 DQ 1

Approximately half of individuals seeking SUD treatment meet criteria for current PTSD, and individuals with co-occurring PTSD-SUD tend to have poorer treatment outcomes compared with those without such comorbidity. It is important to recognize that once an individual meets criteria for both disorders, they influence each other. One of the most widely recognized and studied non-exposure based treatments for this is Seeking Safety which consists of an average of 25 60-90 min session covering a wide variety of topics such as decreasing risky behaviors, setting boundaries and coping with substance triggers. I would go about treating clients by first assessing their co-occurring disorders. Although cognitive behavioral therapy is what I would go for, medical interventions may be necessary to help clients because this can be life-threatening when suffering from withdrawal symptoms or extremely uncomfortable symptoms. Working with a care team is what is needed. (Physicians, pharmacists, counselors and therapist) Integrated treatment has also been widely used. This treatment model acknowledges the undeniable connection between substance use and PTSD. With this treatment both are addressed at the same time.

Kim.

My response:

Good afternoon Kim

Re: Topic 5 DQ 1

In a case such as this the first thing as a counselor I would do is to ensure the safety of the client and safety of others as well. From that point on I would suggest to the client that it is important to treat both disorders at the same time and to start with a therapy like Cognitive Behavioral Therapy. Having the client also attend meetings for PTSD would be important. Other options that would work in conjunction with therapy would be having a family counseling session with family members as this would help repair any relationships and give the family members an idea of how to deal and cope with this type of co-occurring disorder. Medication could be an option to help ease the withdrawal symptoms and to help prevent relapse. There are other avenues such as inpatient treatment that a client could seek if outpatient therapy and group meetings were not enough.

Reference:

Foundation Recovery Network. (2019). Post Traumatic Stress Disorder and Addiction. Retrieved from https://www.dualdiagnosis.org/mental-health-and-addiction/post-traumatic-stress-disorder-and-addiction/

Sharon

My response:

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