Trilogy Blog

Trauma-Informed Care and Substance Use Treatment

Posted by Shawna Flavell on Fri, Oct 10, 2014 @ 03:11 PM

Last month, Regina Moffett, Certified Recovery Support Specialist and Trilogy advocate, was the keynote speaker at the National Council for Behavioral Health’s Trauma-Informed Care Learning Community for Addictions Programs kick-off conference in Baltimore, MD. Her presentation, The Intersection of Trauma and Addictions: A Trauma-Informed Recovery, focused on Trilogy’s trauma-informed approach to addiction treatment.

2014092595162611 1 resized 600(l to r) Regina Moffett, CRSS; Cheryl Sharp, Senior Advisor for Trauma Informed Services at The National Council for Behavioral Health, Linda Ligenza, Clinical Services Director at The National Council for Behavioral Health

In 2012, Trilogy began to implement trauma-informed care (TIC) into every aspect of the organization. This included enhancing all of our programs and services to ensure that everything we do contributes to Trilogy’s goal of being an ideal TIC organization. A key component of our TIC implementation was to ensure that peers were well-represented in all of our efforts.

“Working as the Coordinator of the Trilogy Beacon for four years, helping the organization create a trauma-informed space, and being a part of Trilogy’s own learning leadership community opened many doors for me,” says Regina. “Looking back at the mental health system over the past 20 years, it is amazing to see the way that treatment of mental illness and substance use has evolved. Being a part of the Trauma-Informed Learning Community for Addictions Programs kick-off in Baltimore, MD has only strengthened my belief that peers hold a valuable position in the workforce and are changing lives every day. I credit the National Council and all the advocates of recovery for making it possible for me to share my lived experiences—both with mental illness and substance use—and assisting me in developing my leadership role as the Coordinator of the Trilogy Beacon and now in my current position with Chicago House.”

When we enhanced our substance use treatment program in 2013, it was imperative that it be trauma-informed and that we involve peer specialists as providers and supports. Trilogy provides Integrated Dual Disorders Treatment (IDDT) services because the best available research consistently demonstrates that mental illness and substance use disorders impact each other and that they are most effectively treated when they are treated together. Adverse Childhood Experiences (ACE) researchers discovered that the risk factors for a person who scores a four or more on the ACE survey, which measures the number of traumatic incidences a person experienced while growing up, increase drastically for substance use. This includes being seven times more likely than someone with less trauma in their past to develop alcoholism, ten times more likely to use injected drugs, and over four times more likely to use illegal drugs1. Trauma is a risk factor in nearly all behavioral health and substance use disorders and our IDDT Program uses a trauma-informed approach at every stage of treatment.

Every client enrolled in Trilogy’s IDDT Program has a trauma history: There are no exceptions. We understand substance use may represent an effort to manage symptoms of that trauma. Stressing safety, choice, and collaboration at every stage of the treatment process is one way we ensure that people seeking treatment for their substance use are given trauma-informed care. There is at least one peer on each primary treatment team at Trilogy and our IDDT team works closely with a person’s team in order to coordinate care and to tailor each person’s substance use treatment plan to where they are in their recovery. They also make sure that the individual is an active participant in their treatment and are willing to explore their substance use and its possible impact on behavioral health treatment and quality of life. We normalize and actively seek to decrease shame and secrecy around traumatic stress symptoms, including substance use, and focus on harm reduction for those individuals who may not be ready to abstain from substances entirely. Harm reduction is crucial because these strategies may help to spare the client further traumas that might amplify the impact of past traumas. We also promote the development and implementation of new coping skills and sober supports in order to minimize substance use and the impact it has on the life of the individual, often time through groups that are co-lead by peers and an IDDT specialist.

As we continue to provide trauma-informed care to each person we work with, it’s important for us to remember that people can and do recover from trauma and the impact it has had on them. This includes substance use. It is our job as behavioral health providers to provide people with the information they need to make educated decisions which acknowledge the impact their past traumas have had on their lives and leave them feeling empowered to make the choices which improve their lives.


Tags: recovery, trauma-informed care, trauma, mental illness, mental health, IDDT, substance abuse, national council for behavioral healthcare, Cheryl Sharp, peer specialist, mental illness awareness week