with Sonja Batten, PhD; Jason DeViva, PhD; Mark Mann, PhD; Lorie Morris, PsyD; Andrew Santanello, PsyD; Melissa Decker, PsyDBuy with CE Credit
Although posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) are commonly co-occuring conditions (Brady, 2001; Helzer et al., 1987; Stewart, 1996; Tarrier & Sommerfield, 2003), traditionally, it has been recommended that an individual must first receive successful substance abuse treatment before posttraumatic symptoms can be addressed. Given the high comorbidity of these conditions, however, it would be helpful if more broadly focused therapies were available that simultaneously targeted common functional processes underlying the multiple problems of the dually diagnosed.
Both PTSD and SUDs can be conceptualized as disorders with significant experiential avoidance components. One treatment specifically developed for the treatment of experiential avoidance is Acceptance and Commitment Therapy(ACT). This workshop will describe the use of ACT to guide treatment focused on comorbid PTSD and SUDs, as first outlined by Batten and Hayes (2005). As both PTSD (Batten, Orsillo, & Walser, 2005; Orsillo & Batten, 2005) and SUDs (Mirin et al., 1987; Woody et al., 1984) have been conceptualized as disorders of avoidance, an intervention such as ACT fits easily into a model of their concurrent treatment. The presenters will describe a treatment program that has been in existence for over four years for the treatment of these comorbid disorders.
Program evaluation efforts are underway for this model, and the data show that individuals who participate in an ACT-based program that concurrently treats PTSD and SUDs in individuals with very low lengths of prior sobriety is effective in significantly reducing scores on validated measures of PTSD (PTSD Checklist, Mississippi Scale for Combat Related PTSD), as well as frequently reported problems related to trauma, such as sleep disruption(Fear of Sleep Inventory). Supporting the model of ACT being a treatment of experiential avoidance, scores on theoretically relevant measures, of avoidance (Acceptance and Action Questionnaire) and anxiety sensitivity (Anxiety Sensitivity Inventory) are also significantly reduced by this treatment program. Data supportive of this approach will be provided in the workshop, and detailed interventions to illustrate the ACT model for this population will be presented. Specific considerations for clinically relevant anger and acceptance-based exposure treatment in traumatized individuals will be demonstrated.