RCT Treatments for Substance Abuse & PTSD

Reciprocal concurrent therapy (RCT) refers to concurrent treatment provided for two different problems, such as substance abuse and PTSD, at the same time. The "Croatian Medical Journal" reports that posttraumatic stress disorder (PTSD) is strongly correlated to substance abuse as evidenced in many cases involving veterans of combat exposure, victims of traumatic events such as rape or spousal battering abuse and disaster victims. Research demonstrates that as many as 60% to 80% of PTSD sufferers also have substance abuse problems, therefore PTSD must be treated concurrently with substance abuse disorders in many cases.

Seeking Safety Model

• One example of concurrent treatment of PTSD and substance abuse is the model known as Seeking Safety, which teaches coping skills based on 25 topics related to PTSD and substance abuse disorders. The model also covers all four domains: behavioral, interpersonal, cognitive and case management. It is designed to treat people of either gender who experience any type of PTSD and who abuse any substance. Seeking Safety can be provided individually or as group therapy. In order to be successful, concurrent treatment methods must likewise address both PTSD and substance abuse symptoms adequately.

Concurrent Therapy

• Concurrent therapies for PTSD and substance abuse generally combine treatments that have been proven to be effective in the treatment of both disorders when they are treated separately. Proven treatments for substance abuse usually include treatments within the realm of cognitive behavioral therapy (CBT), while treatments that have been successful in the treatment of PTSD involve stress inoculation training techniques.

CBT

• Cognitive behavioral therapy (CBT) is a very general term applying to a number of therapy techniques within a group, including rational emotive behavioral therapy, rational behavior therapy, rational living therapy, cognitive therapy and dialectical behavior therapy (DBT). Cognitive behavioral therapy holds that our behaviors stem from our thoughts, rather than through outside circumstances involving people, situations or events. Cognitive behavioral therapy is generally brief and time limited.

Stress Inoculation Training

• Stress inoculation training is designed to teach PTSD sufferers how to gain confidence in their ability to deal with associations related to the traumatic event that initially caused their PTSD symptoms. During the first phase of stress inoculation training, the therapist assists the PTSD sufferer in the recognition of trauma-related associations that cause PTSD symptoms. Once recognition of related associations is firmly established, relaxation techniques such as muscle relaxation and deep breathing are introduced to the client, and the sufferer is taught to practice these relaxation techniques when trauma-related stress occurs to gradually resolve PTSD issues and eliminate related responses.

Qualified Professional

• Successful treatment of individuals dually diagnosed with substance abuse disorders and PTSD requires a person knowledgeable in both fields. The counselor or therapist taking on such a task should be experienced in both the treatment of substance abuse and posttraumatic stress disorder. Ideally, the counselor should be a licensed professional counselor (LPC) or licensed clinical social worker (LCSW or LICSW), who is also a certified substance abuse counselor. If such an individual is not available to treat the individual or group, the treatment process should involve a team of professionals who are able to treat both issues adequately, since clients dually diagnosed with substance abuse and PTSD require both cognitive behavioral therapeutic techniques and stress inoculation training for the treatment to be effective.