Dr. Christina Basedow, EHN Canada
September 6th 1:30 pm Theatre Room
The clinical issue of trauma is pervasive in substance use populations. Van der Kolk (1987) asserts that trauma is the end result of an individual’s exposure to a stressful event that overwhelms their ability to cope. In many instances, the result of traumatic experiences can lead to the development of Post Traumatic Stress Disorder (PTSD). Research indicates a prevalence of comorbidity between PTSD and Substance Use Disorders (SUD). McCauley et al.,(2012) highlights how the comorbidity of PTSD and SUD presents a more complex and costly clinical course when compared with either disorder alone.
This includes more chronic physical health problems, poorer social functioning, higher rates of suicide attempts, worse treatment adherence, and ultimately, less improvement during treatment (2012). These realities highlight the importance of clinically addressing both PTSD and SUD in an integrated treatment approach in order to maximize the recovery capital obtained by the patients in treatment. Edgewood Health Network’s established exposure-based integrated treatment program seeks to address the complicated comorbid presentations of PTSD and SUD.
The Concurrent Trauma and Addiction Program (CTAP) is designed for members of the Canadian Forces Veterans Affairs Canada, the RCMP, and First Responders with concurrent symptoms of PTSD and operational stress injury along with SUD. The program utilizes components of CBT, DBT, mindfulness meditation, and other clinical modalities to address the trauma injury. The substance use component is addressed by integrating the aforementioned procedures with a 12-step model which emphasizes social connection and a unique person-centered spiritual awareness.
The program is designed for a 63-day implementation within the context of residential treatment. It involves individual and group therapy sessions and mindfulness meditation, facilitated by the increasing development of a strong therapeutic rapport with the patient. This prepares the patient for transition into the community where they continue to both utilize and grow their recovery capital.
The beginning phase of the CTAP program is to establish safety and security for the patients and help stabilize the trauma patients. The learning objective in this phase is for the patients to gain awareness of their respective trauma symptoms and to receive basic mindfulness and grounding techniques to begin learning how to recognize triggering symptoms and to employ self-grounding techniques. It is in this context of safety and stabilization that the patients are then prepared for deeper connection with their therapist and group therapy peers that they can begin more intensive exposure therapy.
The second phase of the program involves trauma processing and desensitization. This includes the utilization of CBT and DBT therapy to facilitate cognitive processing and behavioural modification. Additionally, narrative therapy techniques are used to facilitate the process of memory reformation. The goal of this phase is to increase the patient awareness of unconscious cognitive and emotional processes related to their traumatic memory triggers, and to begin consolidating increased behavior change via DBT skills to help the patient regulate their emotions.
The third phase of the program involves the integration with 12-step concepts to facilitate pro-social connections between the patient and his/her respective peers. The 12-step recovery community is broad and extensive within the general population and provides an avenue for continued support for the patient to further consolidate their learned self regulation skills and grow their recovery capital with ongoing concurrent trauma and substance use therapy. This process is facilitated in partnership with the patient’s pre-existing clinical mental health team, and a connection with the Edgewood Health Network’s many outpatient treatment facilities throughout. The patients are given the skills to connect with healthy individuals in the community for ongoing emotional, psychological, social, and spiritual support for maintained recovery from both their PTSD and SUD symptoms.
Dr. Christina A. Basedow has a strong passion for working in the addictions field. She has been working with individuals, couples, and families struggling with substance misuse issues, mental health disorders, and co-dependency issues. Christina is skilled in a variety of areas including family counselling, eating disorders, sexual compulsions, and CBT/DBT. Christina brings her personal experience, compassion, and a wealth of knowledge in psychology, research, and teaching, to her clients, and to EHN. Christina is registered with the BC Association of Registered Clinical Counsellors and holds aPh.D.D in Psychology. She is also currently a Certified Sex Addiction Therapist Candidate.
Recovery Capital Conference of Canada
September 6th and 7th, 2018