Helping or Harming? The Impact of Exploring Trauma Within a Men’s Residential Addiction Treatment Program

Abstract

Substance abuse and trauma experiences have a high comorbidity and are more likely to co-occur than not (Farley et al., 2004; Tripp et al., 2019; van Dam et al., 2012). The cooccurrence of trauma and substance use is associated with greater symptom severity for both issues, poorer treatment outcomes, and higher rates of drop out from treatment (V. B. Brown et al., 2013; Roberts et al., 2015; van Dam et al., 2012). Historically, substance abuse and trauma have been addressed separately in treatment through independent (both issues are addressed through independent programs that do not co ordinate care) or sequential (one issue is prioritized and addressed individually before addressing the other) treatment programs (Hermann et al., 2014). Some practitioners and treatment programs hold the belief that incorporating trauma care within substance abuse treatment can result in triggering relapse, jeopardizing a person’s sobriety or recovery, or exacerbating the individual’s trauma issues (V. B. Brown et al., 2013; Covington et al., 2008; Lortye et al., 2021) despite support for the effectiveness of integrated treatment wherein both issues are addressed together within a singular program (Blakey & Bowers, 2014; Dass-Brailsford & Myrick, 2010; Tripp et al., 2019; Vujanovic et al., 2018). It is well established within the literature that there are gender differences in experiences of substance abuse and trauma (Cosden et al., 2015), which supports the need for gender-responsive treatment. This research assesses a specific gender-responsive integrated group therapy treatment for men, implemented within a residential addiction treatment program that has not been previously assessed. It focuses on analyzing a specific two-week portion of the overall treatment that explores the role of trauma in a person’s substance abuse issues and how it impacts their goals of recovery to determine potential iatrogenic effects of exploring trauma (i.e., worsening symptoms, and increased drop out from treatment). Participants were recruited from Wayside House of Hamilton and completed a baseline assessment, an assessment before beginning the specific portion of treatment exploring the role of trauma in substance abuse, and an assessment after completing this trauma centred section of treatment. Participant attendance in group sessions throughout the program was also tracked. Paired sample t-tests revealed no significant changes across measures of hope, self-esteem, and sleep disturbance - indicating there was no worsening of symptoms – and a significant decrease in distress caused by trauma symptoms – indicating improvements in trauma symptomology. Analyzing drop outs from treatment revealed no significant differences between the sections of programming during which participants prematurely terminated treatment, indicating there is no evidence to suggest individuals experienced intense distress specific to the trauma module presenting as increased drop out. This research lends support for the use of the Exploring Trauma module for integrated treatment of substance abuse and trauma within a men’s residential program.