Key Take-Aways from NASW’s Trauma & Addictions Workshop

The New York City Chapter of the National Association of Social Workers (NASW) provided a wonderful program with 34 different seminars about Trauma and Addictions Across the Life Cycle.

The key take-aways from my day were as follows:

Prevalence of Post Traumatic Stress Disorder

• 61% of men and 51% of women in the U.S. have experienced at least one traumatic event in their lifetime.
• There is a positive correlation between severe trauma and depression, post-traumatic stress disorder (PTSD) and substance use disorders.
• Estimated average lifetime rate of PTSD in the U.S. is 9% (i.e., very low prevalence of PTSD compared to prevalence of trauma)
• While more men are traumatized, more women are more likely to suffer from PTSD (females suffer from PTSD at a 3x higher rate than males).
• A person’s risk of PTSD increases with increased exposure to life-threatening/traumatic events.

Children/Adolescents

• Traumatized preschool children are likely to display passive and regressive symptoms such as decreased talking and clinging behavior.
• School age children may exhibit both more aggression and inhibition as well as somatic complaints, depression and learning difficulties (as a result of impaired concentration and memory problems).
• Adolescents tend to act-out and engage in self-destructive behavior (such as promiscuity, delinquency and substance use).
• Trauma, especially complex (the type that lasts for years) trauma in early life, affects the part of the brain which regulates mood and social adjustment and leads to increased vulnerability to substance abuse.

Adults

• There are high rates of comorbidity between PTSD and substance use disorder:

Between 20 to 45% of patients receiving substance use disorder (SUD) treatment meet the criteria for PTSD

Up to 80% of the female patients receiving SUD treatment have a history of being sexually or physically assaulted.

Treatment

• Effective treatment approaches include: psychoeducation, cognitive behavioral therapy (CBT), exposure/densensitization therapy (such as Eye Movement Desensitization and Reprocessing and Seeking Safety), group psychotherapy and medications.

Helpful websites

www.istss.org  >  International Society for Traumatic Stress Studies
PTSD Screening Tools
www.traumaweb.org > Israel Center for the Treatment of Psychotrauma

II. Seeking Safety: Model for Trauma and/or Substance Abuse

• Meaning of substances in the context of PTSD:

To access feelings or memories
To shut off feelings or memories
As revenge against abusers
As re-abuse of self
As a slow suicide
As a learned behavior

• Transformation of Identity > as part of recovery:

from victim to survivor
silence to finding one’s voice
powerlessness to sense of control
isolation to connection

• How is PTSD addressed?

Not at all?

Focus on the present (psychoeducation, coping skills and

seeking safety;

under-utilized)

Focus on the past (describe trauma via EMDR etc; most clinicians practice this; even though these are effective, there are issues with unstable clients and/or clients in short-term treatment)

Seeking Safety:

• Training or a treatment
• Highly flexible (length, format etc.)
• Easy and low cost
• Used for over 16 years
• Can be used as a general stabilization model
• Originally developed for trauma/substance use disorder, but is applicable for any type of trauma
• For multiple co-occurring conditions (Axis I, II)
• 25 different topics (in any order)
• Group or individual sessions
• Open or closed groups
• Adult or adolescent
• Outpatient, inpatient or residential

Session Format:

• Check In
• Quotation [Sharing a relevant quotation]
• Content [Relate topic to current and specific problem included in client’s life)
• Check Out

Partial List of Topics:

• Safety
• PTSD: Take back your power
• Substance abuse
• Asking for help
• Detaching from emotional pain (grounding)
• Taking good care of yourself
• Setting boundaries in a relationship
• Community resources
• Creating meaning
• Coping with triggers
• Healing from anger
• Integrating the split-self

This model sounded like a powerful treatment method and I would have loved to have learned more about it. Fortunately, Lisa provides lots of information about this model at Seeking Safety.

Aside from Seeking Safety, Lisa Najavits shared that she and her team are working on a new model: Creating Change which is currently being tested. This model focuses on the second phase of treatment, that is, the mourning phase.

III.  Intergenerational Transmission and the Field of Traumatic Stress

This workshop primarily consisted of a very interesting and heartfelt discussion between the panel members and the rest of the participants.

Basically, it was shared how the effects of past historical traumatic events such as genocide and slavery have an impact not only on the generation where the traumatic event took place but on the generations that follow in all kinds of ways (including substance use disorders).

The following beautiful healing song was shared at this workshop:

I am healing, [rub hands]
You are healing, [snap fingers]
We are healing, [stamp feet to feel connection with mother earth]
Our world is healing, [take deep breath in]

I am healing, [rub hands]
You are healing, [snap fingers]
We are healing, [stamp feet to feel connection with mother earth]
Our world is healing, [take deep breath in]

We repeated this song each time someone shared a difficult story/memory. There was something comforting in sitting in a circle and saying these healing words together.

In sum, I felt that this was a valuable workshop to attend. It was the perfect one to augment the post- graduate class I am currently taking that is titled “Clinical Practice with Substance Abusers and their Families.”

What are your thoughts about the topic of trauma and addictions? What has been your experience with the “Seeking Safety” treatment model? Please share your comments below.

References:

Muid, O., Spinner, A., Eaglewoman McGillis, E.T. & Burns, L. (June 6, 2012). American intergenerational trauma: the African American, Jewish American and American Indian experience, NASW AI.
Najavits, L. (June 6, 2012). Seeking safety, NASW AI.
Straussner, L. (June 6, 2012).  An Overview of trauma and addictions through the life cycle: What we know and what are the treatment implications, NASW AI.