Trauma-Informed Treatment: Research-Based Interventions

Trauma-Informed Treatment: Research-Based Interventions


This is part three of the three-part series, Trauma-Informed Addiction Treatment and Research-Based Interventions. Read part two, The Relationship Between Trauma and Substance Abuse


A trauma-informed approach to treatment, according to the Substance Abuse and Mental Health Services Administration, is one that:

  • Realizes the widespread impact of trauma and understands multiple pathways for recovery
  • Recognizes the signs and symptoms of trauma in clients and families
  • Responds to trauma by fully integrating knowledge about it into practices, procedures and policies
  • Actively works to prevent re-traumatization

A successful trauma-informed approach will include interventions that are based on trauma research and the psychosocial, educational and empowerment principles that have long been used in public system settings. Following are some of the most commonly used and successful research-based interventions for trauma-informed treatment:

Seeking Safety

Seeking Safety is an evidence-based counseling model that focuses on the present rather than the past and is designed to help individuals regain a sense of safety from trauma and substance abuse. While it addresses both trauma and addiction, it doesn’t delve into detailed accounts of the trauma. The twenty-five topics covered under this model can be addressed in any order.

The topics include:

  • PTSD: Taking Back Your Power
  • When Substances Control You
  • Setting Boundaries in Relationships
  • Creating Meaning
  • Integrating the Split Self
  • Taking Good Care of Yourself
  • Detaching from Emotional Pain (Grounding)

This model operates on several key principles:

  • Safety as the priority of treatment
  • Integrated treatment
  • A focus on ideals
  • Four content areas: cognitive, behavioral, interpersonal and case management

Seeking Safety is very flexible. It can be presented in group or individual settings, and it works well for men and women, adults and adolescents and people in all levels of care.

Risking Connection

Risking Connection is a trauma-informed model for various levels of mental health, public health and substance abuse staff. It emphasizes relationships as central to the healing process as well as the importance of self-care for providers.

This model is based on RICH relationships—those characterized by respect, information sharing, connection and hope. It focuses on the concepts of empowerment and collaboration to help caregivers understand how trauma causes pain, how connection and relationships can be used as treatment tools, and the importance of maintaining a trauma framework when responding to crises and working with dissociation and self-awareness.

Acceptance and Commitment Therapy

Mindfulness interventions are intentional, non-judgmental and accepting practices that focus on teaching people how to pay attention to their thoughts and feelings in the moment.

Acceptance and commitment therapy is a mindfulness intervention that helps individuals think and act in ways that support their personal values while developing psychological flexibility. Through ACT, clients recognize the challenges of their attempts to suppress, control and manage negative emotional experiences. In doing so, they become more adept at making healthy decisions that promote well-being.

The six core processes of ACT are:

  • Acceptance over avoidance
  • Cognitive diffusion techniques that help individuals change the way they interact with their thoughts
  • Being present in a non-judgmental way
  • Self as context, or being aware of one’s own experiences without attachment
  • Values, or one’s judgments of what is important in life
  • Committed action, or developing larger patterns of healthy behaviors linked to chosen values

Dialectical Behavior Therapy

Dialectical behavior therapy is another mindfulness-based intervention designed to help clients develop skills for managing difficult emotions and reducing conflict in their relationships. Problematic behaviors evolve as coping mechanisms, and while they may offer short-term relief, these behaviors lead to more problems in the long-term.

DBT helps clients learn new behaviors and enhance their capabilities by learning new coping skills in a variety of areas, including:

  • Mindfulness
  • Distress tolerance
  • Regulating emotions
  • Interpersonal relationships

DBT is divided into four treatment stages:

Stage 1 moves the client from being and feeling out of control to achieving control over their behaviors.

Stage 2 moves the client from feelings of quiet desperation to full emotional experiencing. This is the stage where PTSD is treated.

Stage 3 is all about learning to live. The client defines life goals, builds self-respect and finds peace and happiness.

Stage 4 is for clients who wish to find deeper meaning through spirituality and helps them move from a feeling of incompleteness toward feelings of joy and freedom.

DBT is an evidence-based therapy that’s been shown to reduce suicidal behaviors, self-injury, substance abuse and anger resulting from past trauma.

Mindfulness-Based Relapse Prevention

Relapse prevention is central to successful addiction recovery. Mindfulness-based relapse prevention is a model that eschews the common belief that relapse is a “sleeping tiger” ready to pounce when least expected.

The primary goals of MBRP are to:

  • Develop awareness of one’s habitual reactions and personal triggers for relapse and learn how to pause these automatic processes for closer inspection
  • Learn how to be okay with being uncomfortable
  • Recognize challenging emotional and physical experiences and develop skills to respond to them in healthy ways
  • Develop self-compassion and a nonjudgmental approach toward oneself and one’s experiences
  • Build a healthy lifestyle that supports mindfulness and a life of recovery from trauma and substance abuse

Mindfulness-Based Meditation

Mindfulness meditation is a meditation technique that can help individuals manage distracting thoughts and feelings by staying aware of the thoughts, feelings and sensations in the present moment. A growing body of research shows that mindfulness meditation is an effective treatment for a wide range of physical and psychological ailments and has been associated with decreased stress, depression, anxiety, pain and insomnia.

Recent research by neuroscientists at Harvard Medical School and Massachusetts General Hospital found that regular meditation practice actually changes the brain, increasing the amount of gray matter in the auditory and sensory cortex and in the frontal cortex, which is associated with executive decision making and working memory. The study also found that following four regions of the brain thickened after just eight weeks of meditating:

  • The posterior cingulate, which is involved in self-relevance and mind wandering
  • The left hippocampus, which is involved in learning, cognition, memory and regulating emotions
  • The temporoparietal junction, which is associated with perspective, empathy and compassion
  • The pons, which is where many regulatory neurotransmitters are produced

Additionally, the amygdala, which is involved in anxiety, stress and fear, experienced a reduction in size after eight weeks of mindfulness meditation.

SAMHSA’s Six Key Principles of a Trauma-Informed Approach

According to the Substance Abuse and Mental Health Services Administration, a trauma-informed approach adheres to six key principles rather than a pre-ordained set of procedures and practices.

These principles are:

  1. Safety
  2. Trustworthiness and transparency
  3. Peer support
  4. Collaboration and mutuality
  5. Empowerment, voice and choice
  6. Cultural, historical and gender issues

Trauma permeates all areas of an individual’s life, and when it co-occurs with a substance use disorder, the result is often devastating to their relationships, physical and mental health, finances, quality of life and sense of well-being.

Through a trauma-informed approach to addiction treatment using research-based interventions, individuals can safely and effectively restore their lives after trauma and end an addiction for the long-term.


Download this entire series as a beautifully designed eBook, Trauma-Informed Addiction Treatment and Research-Based Interventions


Campus Resources to Look for When You’re Struggling With Addiction

Campus Resources to Look for When You’re Struggling With Addiction

College is a time for growth, change and discovery. It’s a time to figure out who you are and plan for your future, but the freedom of the college lifestyle often fuels the use of drugs and alcohol. You may unwind after a busy week of studying by having drinks with friends, or you may use drugs or alcohol to loosen up in social situations. Some students also turn to Adderall or other “study drugs” for help powering through lengthy study sessions.

When the use of these substances is closely linked with your social life or academic life, it can be easy for substance use to develop into substance abuse. In this article, we’ll talk about some campus resources that can help you when you’re struggling with addiction.

Identifying a Problem

It’s typical for college students to think they can handle their current rate of drug or alcohol use, but a few key warning signs can let you know that your substance use may have become a problem:1

  • Loss of control: You’re drinking or using more than you wanted to, or you’re doing it even though you swore you wouldn’t
  • Increased tolerance: You find yourself needing to drink or use more in order to achieve the desired effects
  • Neglecting interests and activities: You’ve stopped participating in routine activities or hobbies; you may be spending less time with family and friends
  • Ignoring negative consequences: Substance abuse is causing problems in your life—your grades may be suffering, relationships may be strained or you may even be experiencing health problems—but you continue to drink or use anyway

Where to Turn

If you recognize any of these classic signs of addiction, it’s important to address the problem as soon as possible. A good starting point is your college’s student health clinic. They can perform an initial consultation and refer you to nearby treatment centers for further evaluation.

Addiction During College Campus Resources to Look for

The majority of colleges and universities have student help lines that you could can for guidance. Many colleges also have a counseling center or department of psychiatric services that can help students who are concerned about a substance abuse problem. Check your college or university’s website for a complete list of available services.

What to Expect

Once you reach out to a professional for help through campus resources, you can start discussing treatment options. For some substances, medical detox is necessary. This process allows the substance to safely leave your body and helps manage uncomfortable withdrawal symptoms.2 Psychological and behavioral counseling helps you address the root issues that may have fueled your substance abuse; this type of counseling also helps you develop the coping skills you’ll need to deal with cravings and triggers. After you complete treatment, you’ll want to participate in recovery resources such as support groups, continued counseling or 12-step programs. These resources provide valuable support and motivation to help you manage the challenges of recovery.

Admitting that drug or alcohol use has become a problem in your life is a big step in the right direction. Reaching out for help is the next important step. Remember that you’re not alone—help and support are available right at your college. With the guidance of these campus resources, you can determine the best treatment options for your needs and get on the path to recovery.


References:

  1. https://www.ncadd.org/about-addiction/signs-and-symptoms/signs-and-symptoms
  2. https://www.drugabuse.gov/publications/teaching-packets/understanding-drug-abuse-addiction/section-iii/7-medical-detoxification
Don’t Be SAD: 6 Healthy Ways to Cope With Seasonal Affective Disorder

Don’t Be SAD: 6 Healthy Ways to Cope With Seasonal Affective Disorder

Seasonal affective disorder, or SAD, is a type of depression that occurs most often during the late fall and early winter months and lasts until spring or summer. For people in recovery from an addiction, this condition poses a serious challenge. Feelings of depression are a major trigger for relapse, and coping with them effectively is crucial for ongoing success in recovery.1

If you’re experiencing low energy, excessive sleepiness in the daytime, intense carb cravings and social withdrawal, you may have this disorder. The good news is that seasonal affective disorder is treatable with therapy or medications like bupropion and selective serotonin reuptake inhibitors. A combination of medication and therapy is the most effective treatment for SAD, according to the National Institute of Mental Health.2

In addition to medication and therapy, there are a number of effective strategies that can help you cope with seasonal affective disorder. Here are six tried-and-true techniques.

1. Try light therapy.

Light therapy is a mainstay for treating seasonal affective disorder. Bright, artificial light from a special light box replaces the diminished sunshine, and sitting in front of the light box upon waking up each day has been shown to reduce symptoms of SAD. Light boxes typically produce 10,000 lux of cool-white fluorescent light, which is around 20 times brighter than normal indoor lighting.

2. Take vitamin D.

Low levels of vitamin D are often found in people with SAD, and upping your vitamin D intake by taking supplements or sitting in the sunshine—or in front of a light box—for 10 or 15 minutes each day can’t hurt.

3. Keep the curtains open.

Seasonal affective disorder is typically worse in the morning. Let as much natural light as possible into your home as soon as you wake up, and keep the curtains open when the sun’s out during the day and evening.

4. Stick with a routine.

Maintaining your daily routine can help you cope with seasonal affective disorder by keeping you busy and active. Don’t stop going to the gym, attending support group meetings or engaging in hobbies and social activities. Hibernating can make SAD worse by making you feel lonely and isolated. Social withdrawal is also detrimental to addiction recovery.

5. Exercise.

Cope With Seasonal Affective Disorder

Regular exercise can dramatically improve your mood by releasing feel-good brain chemicals known as endorphins. Exercise has been shown to be as effective as medication for treating mild to moderate depression.3 Strive to get a half hour of moderate-intensity exercise most days of the week.

6. Practice yoga or meditation.

Mindfulness exercises and breathing exercises can have a profound effect on depression and anxiety. In fact, recent research has found that meditation can actually change the neural networks in the brain to reduce stress and symptoms of depression. Both yoga and meditation, when practiced regularly, can help reduce symptoms of seasonal affective disorder and improve your overall sense of well-being.

When to Get Help for Seasonal Affective Disorder

Depression in recovery should be addressed as soon as possible. If you feel like your symptoms are reducing your quality of life and taking a toll on your well-being, talk to your therapist, physician or other medical or mental health professional. You don’t have to suffer with SAD, and getting professional help will support the healthy lifestyle central to successful recovery.


References:

  1. https://store.samhsa.gov/shin/content/SMA12-4474/SMA12-4474.pdf
  2. https://www.nimh.nih.gov/health/topics/seasonal-affective-disorder/index.shtml
  3. https://www.health.harvard.edu/mind-and-mood/exercise-is-an-all-natural-treatment-to-fight-depression
8 Ways to Cope With the Chaos of Family Holiday Events

8 Ways to Cope With the Chaos of Family Holiday Events

You love your family, but that doesn’t mean they don’t make you crazy from time to time. This can be especially true during family holiday gatherings.

If you’re newly sober, you’re not going to be able to use alcohol or drugs to dull negative emotions or take the sting out of certain comments from your well-meaning but deeply misguided great-aunt Mabel, but that’s okay. You’ve got this.

Here are eight ways to cope with the chaos and have a good time at family holiday gatherings this season—without endangering your recovery.

1. Set limits and boundaries, and stick to them.

Setting boundaries is one of the most important factors for successful recovery.1 Boundaries help prevent you from being abused or manipulated, and they help establish healthier relationships with family members. Set your boundaries, and calmly enforce them.

2. Bring along support.

Bring a supportive friend along for moral support. Having a friend to talk with about any shenanigans by family members can help deflect unpleasant emotions, and it can even help you find the eye-rolling humor in a situation. It may also help inspire family members to be on their best behavior.

3. Have an out.

If things get to be too much, it’s time to leave. You needn’t make a big to-do about it, but have a plan of action in the event it comes to that point. Leave quickly, quietly and gracefully, and if you need support once you’ve left, ask a friend or sponsor for help right away.

4. Hit a meeting before you go.

If you think you’re going to need a lot of support to get through a family gathering intact, find a support group meeting to attend before you go. Your group can give you encouragement and confidence as well as offer helpful tips and strategies for coping with any unpleasantness.

5. Visualize, visualize, visualize.

Cope With the Chaos of Family Holiday Events

Don’t proverbially trek out into the gathering cold. You know your family best of all, and you’re familiar with potential scenarios that can throw you off your game. Calmly visualize the worst-case scenarios, and walk yourself through handling them in a way that will make you proud to be you.

6. Try not to sweat the small stuff.

If little things your family does tend to make you nuts, such as your sister making snide comments about your past or your mother nagging you about your unruly hair or lack of a mate, make a conscious decision to let it go. Tell your sister that you’ve moved on from your past and she should, too, or hug your mother and tell her you like your crazy hair, and there are far worse things than being single. Then walk away, and engage in a cheerful conversation about rock ‘n’ roll with your funny younger cousin.

7. Practice your stress reduction techniques.

Acute stress is an important trigger for relapse.2 When you feel your stress level rising, politely extract yourself from the situation, find a quiet place to be alone, and do some deep breathing or progressive relaxation exercises to lower your stress level and restore calm. Spend a few moments visualizing how you will cope once you return to the chaos, drawing on the strategies you’ve learned in therapy.

8. Let yourself have fun at family holiday events.

Most importantly, allow yourself to have some fun. Try to avoid the usual snares and pitfalls, and stick with the people in your family who make you feel good about yourself or who you can joke around and laugh with. Try to maintain a stable mood, and enforce your boundaries with a light, even humorous touch whenever necessary. Above all, remember why you love this rag-tag group of people—or most of them, anyway—and let the joy and goodwill of the season prevail.


References:

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553654/
  2. https://pubs.niaaa.nih.gov/publications/arh23-4/263-271.pdf
How to Improve Your Diet in Recovery—and Why You Should

How to Improve Your Diet in Recovery—and Why You Should

Good self-care is absolutely central to successful recovery.1 One of the most important ways to take good care of yourself is to eat a healthy diet. But changing your diet can be a challenge if your addiction led to unhealthy eating habits. These can be hard to break. Taking it slow and implementing small, healthy changes over time can help make new habits stick.

This guide is all about what a healthy diet looks like and how to turn your eating habits into a pinnacle of good nutrition.

Why Good Nutrition Is Important in Recovery

Addiction takes a toll on your body. Frequent or prolonged use of drugs or alcohol impacts your overall health. The poor eating habits that often come with addiction further affect the efficient functioning of your body’s systems. Fueling your body with healthy food helps to undo the damage done by addiction and improve your health on many levels.

Here are some the things good nutrition can do for you in recovery:

Reduce withdrawal symptoms. Good nutrition during detox can reduce the intensity of withdrawal symptoms as well as restore good health and a sense of well-being.

Reduce stress. Stress is a major relapse trigger, and reducing it is a central focus in treatment. A healthy diet ensures adequate levels of essential nutrients that reduce your stress hormone levels and help you maintain low blood pressure.

Reduce cravings. Good nutrition helps to reduce cravings by promoting stable blood sugar and correcting nutritional deficiencies that can intensify them.

Improve your mood. A healthy diet promotes optimal brain function, and that includes improving the function of specific brain chemicals related to your mood.

Improve your sleep. Researchers at Pennsylvania University found that a deficiency in essential nutrients like potassium, selenium and calcium can cause insomnia and make it difficult to sleep all the way through the night.2 A healthy diet helps you sleep better, which is another important aspect of self-care.

Manage your weight. Whether your addiction left you underweight or overweight, a healthy diet can help you gain or lose extra pounds for better health.

Repair cell damage. Drugs and alcohol affect your body’s cells, leading to their dysfunction and even killing them. Cell damage done by an addiction can be repaired with a healthy, plant-based diet.3

Help prevent relapse. The National Institutes of Health stresses that a poor diet in recovery puts you at a higher risk for relapse.4

Processed vs. Whole Foods

The key to a nutritious diet is to eat less processed food and more whole foods.

Processed foods are those that have been altered from their original form. They include deli meats and sausages; bread, pastries and candy; dairy products like milk, yogurt and ice cream; and prepared, packaged foods.

Some processed foods, like natural cheeses, milk and oils, undergo processing to make them safe or consumable. Others, like whole-grain breads and low-fat, low-sugar yogurt, can be part of a healthy diet in moderation. Heavily processed foods, though…

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References:

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553654/
  2. http://www.michaelgrandner.com/files/papers/grandnerjackson2013-dietsxs.pdf
  3. http://www.todaysdietitian.com/newarchives/120914p44.shtml
  4. https://www.nlm.nih.gov/medlineplus/ency/article/002149.htm
Single During the Holidays? Don’t Panic

Single During the Holidays? Don’t Panic

Being single during the holidays can be tough if it makes you feel like the odd person out. It can be the bane of your existence at holiday gatherings if your family is waiting with bated breath for you to bring home that special someone. But you don’t have to let being single during the holidays get you down this season. After all, right now, you’re staying focused on your recovery, and a relationship can add an extra layer of stress and complication to your life.

You’ll find romance and love soon enough—probably when you’re least expecting it. In the meantime, here are some helpful tips for being okay with being single during the holidays.

1. Surround yourself with good friends.

Staying busy with friends during the holidays can help take your focus off of being single. Make an effort to engage in enjoyable activities with others. Spend quality time with good friends to reduce feelings of isolation. A healthy social life can make being single during the holidays a lot less lonely, and it’s a pillar of successful recovery, according to the Substance Abuse and Mental Health Services Administration.1

2. Have a plan for handling questions.

If you’re not prepared for it, comments from well-meaning relatives about your singlehood can sting and make you feel conspicuous and inadequate. Don’t let it put a damper on your good time. Come up with some clever or funny comebacks ahead of time to nip that conversation in the bud.

3. Hold a singles event.

Single During Holidays

Plan an epic soiree for the single people in your life. Invite single friends, classmates, co-workers, support group members and even mateless family members. Don’t make it a pity party, but rather a rocking good time with others in your boat. Put on some great music, serve up some delectable dishes and mocktails and pull out some rollicking party games.

A singles event is a good opportunity to broaden and strengthen your support system, and it will serve to remind you that you’re not the only one who’s single.

4. Take a risk.

If there’s someone you’ve been wanting to ask out—even platonically—now might be the time to do it. If you think you can deal with a potential rejection without experiencing a setback in your recovery, why not make the move? Keep it casual, and choose a low-pressure activity. Invite her to a holiday work event, or ask him if he wants to help you shop for Christmas gifts. If not, no problem. If so, you may have a date for that imminent holiday gathering after all.

5. Embrace being single during the holidays, and focus on doing what makes you happy.

Make the choice to embrace being single during the holidays instead of letting it throw a wrench into your enjoyment of life. Do something every day that makes you happy and keeps you busy and active. Dust off your art supplies, challenge yourself to train for a 5k or take up baking.

Engage in fun social activities where singlehood is irrelevant. Join a bowling league, take a drama class or volunteer for a local charity. These things will not only provide more opportunities for getting to know other people, but they’ll also serve you well in your recovery journey. Having hobbies is an essential relapse prevention tool.2

Worrying about being single during the holidays will only add to your stress level. Have a plan of action to stay busy, and have some fun this holiday season to get you through it unscathed.


References:

  1. https://store.samhsa.gov/shin/content/PEP12-RECDEF/PEP12-RECDEF.pdf
  2. https://store.samhsa.gov/shin/content/SMA12-4474/SMA12-4474.pdf