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The sad truth is that many active drug addicts suffer from some type of serious trauma, and they use drugs as a means to cope with their negative emotions. In fact, individuals with post-traumatic stress disorder (PTSD) are 2 to 4 times as likely to have a co-occurring substance abuse disorder (SUD). As a newer type of cognitive behavioral therapy, prolonged exposure (PE) therapy is a specific type of trauma-informed treatment that has proven to be extremely promising for recovering addicts who want to address their trauma-related memories, feeling, and situations. While this may sound overtly triggering, successful therapy effectively helps recovering addicts cope with traumatic memories so they may focus better on their journey to sobriety.

At Silvermist, we have seen many recovering addicts face difficulty trying to cope with their complex post-traumatic stress, and we offer a safe, supportive environment so they can heal peacefully. Because dealing with trauma is such a delicate issue, we use only evidence-based treatment modalities such as PE therapy to ensure the best outcome. By utilizing this approach, our goal is to help patients recognize they do not need drugs to survive or to cope with traumatic life events. This will help you make positive changes and learn other, more effective coping mechanisms when you are tempted to use drugs.

How Prolonged Exposure Therapy Treats Co-Occurring PTSD & SUD

PE therapy has proven highly effective for co-occurring PSTD and addiction, and empirically validated after more than 30 years of research supporting its use. Since being developed in the 1980s, PE therapy has become more and more refined, and now it is used to treat co-occurring PTSD and SUD. In previous decades, patients who had co-occurring PTSD and SUD had to be in partial or full remission from SUD before embarking on PTSD therapy. Fortunately, we now know that both PTSD and SUD can be treated effectively at the same time, with PE therapy.

By helping patients process their traumatic memories, PE therapy can reduce patients’ trauma-induced psychological disturbances. For recovering addicts, this disturbance is specifically related to their drug abuse and all the problems it causes in their lives.

PE therapy involves 2 main types of exposure to help patients address their trauma at their own pace, including:

  • Imaginal exposure: As the name suggest, this involves the patient imagining a past traumatic event while in the comfort and privacy of a psychotherapy session. Together, the patient and psychotherapist discuss and process the emotions raised by the imaginal exposure, in session. The patient is recorded while describing the event, so that they may listen to the recording between sessions to further process their emotions and practice anxiety reduction breathing techniques.

  • In vivo exposure: Outside of sessions, the patient will have to confront feared stimuli as a type of homework. The psychotherapist and patient together identify a range of possible stimuli and situations connected to the traumatic fear, such as specific places or people. They agree on which stimuli to confront as part of in vivo exposure and devise a plan to do so between sessions. The patient is encouraged to challenge him or herself, but to do so in a graduated fashion, so as to experience some success in confronting feared stimuli and coping with the associated emotion.

Is PE Therapy Effective?

Peer-reviewed studies have shown that PE therapy produces clinically significant improvement in about 80% of patients who present with chronic PTSD. By confronting their trauma reminders, the patient begins to change their views about the world and themselves in it. The patient no longer is as triggered about the anticipated harm of innocuous events. They effectively correct their mistaken beliefs and are more aware of which stimuli are provoking, and learn possible safety behaviors to avoid unnecessary triggering of traumatic memories.

Sample PE Therapy Treatment Format

  • Assessment: This involves the psychotherapist and the patient delving into the patient’s history and what stimuli trigger their traumatic memories. This begins in the initial session. The psychotherapist looks for insight into the trauma, as well as the patient’s mistaken beliefs, formulate a list of stimuli, and come up with possible safety behaviors to avoid.

  • Discuss exposure: The psychotherapist will begin with an overview of what the patient can expect from PE therapy. This overview involves warnings of what to expect with PE therapy, as it can trigger very intense emotions in the patient. The patient may cry, panic, become angry, or resist further therapy. They may even experience body reactions as if the traumatic event were happening again. This is when the psychotherapist will remind the patient that it is okay to pause, ground themselves, and breathe, and remind them they are in a safe environment with someone who cares. Sessions do not end until the patient has been given time to process their emotions, which takes advanced planning and structure.

Practice coping techniques: The temptation to use drugs is often strongest when under stress. This thought pattern can be changed through effective treatment with a caring psychotherapist who can redirect the temptations to use drugs into other, healthier and self-esteem-building outlets. Coping techniques will involve cognitive restructuring, such as teaching the patient about whether their beliefs about themselves and thoughts, feelings, and reactions to the world are justified.

  • Develop hierarchy: Together, the patient and their psychotherapist develop a hierarchy of the 4 most relevant traumatic experiences they are trying to process, which can help conceptualize their case and what to expect from PE therapy.

  • Implement exposure: This involves the implementation of both imaginal and in vivo PE therapy modalities.

  • Process: This helps the patient emotionally process what they have done to work on their trauma, and how it relates to their SUD, in particular.

  • Termination: At the end of about 8 to 15 sessions, PE therapy will end, and the psychotherapist and patient will determine how best to terminate their working relationship so the patient may go back to their lives with the learned skills of how to cope with their PTSD and SUD.

Contact Us Silvermist to Learn More

Do you have co-occurring PTSD and SUD? We have seen many patients confront their fears and triggers and go on to live a healthier, substance-free live that is much more fulfilling and rewarding. If you are ready to kick drugs and start a more enriching life where you know how to cope with triggering memories, we are here to help. By utilizing evidence-backed therapies, we hope to reach as many patients suffering from PTSD and SUD as possible, so they may enjoy the sober life and all its benefits.

Interested in learning more about prolonged exposure therapy in Pennsylvania? Contact us at Silvermist today by dialing (724) 268-4858 or contact us online for a quick reply.