We have to put the fire out first before we start rebuilding the house”: Practitioners’ experiences of supporting women with histories of substance use, interpersonal abuse and symptoms of post-traumatic stress disorder

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)
120 Downloads (Pure)

Abstract

Introduction and aims: The high prevalence of women experiencing co-occurring substance use, interpersonal abuse, and symptoms of post-traumatic stress disorder (PTSD) has led to international calls for trauma-specific substance use treatments and wider trauma-informed practice. The aim of this study was to explore how services in England have developed practice responses with limited historical precedence for this work.
Design and Methods: A purposive sample of 14 practitioners from substance use, interpersonal violence and criminal justice services were chosen for their integrated practice. Semi-structured interviews exploring their understanding of the co-occurring issues, staged treatment models and wider trauma-informed practice, and the challenges associated with this. Thematic analysis was employed.
Results: Three key interlinking themes were identified: practitioners’ philosophical approach; tailored clinical practice, and system responsiveness. Analyses identified the importance of relational, non-pathologising practice, extensive focus on physical and emotional safety, and cautionary approaches towards using trauma-specific treatments involving trauma disclosure. Challenges included poor service integration, time-limited treatments and tokenistic trauma informed practice.
Discussion: Practitioners from across disciplines emulated important components of trauma-informed practice and promoted a ‘safety-first’ approach reliant on multi-agency working and wider system responses. Trauma-specific interventions required skilled and experienced practitioners and longer treatment programmes comprising first stage work.
Conclusions: In the context of limited gender-responsive substance use treatment in the UK, practitioners demonstrated integrated practice that supported the recommended staged PTSD model and trauma-informed practice. Organisational leadership and support from service commissioners and funders are recommended to promote growth of this approach across the UK.
Original languageEnglish
JournalADDICTION RESEARCH AND THEORY
Early online date30 Jul 2019
DOIs
Publication statusE-pub ahead of print - 30 Jul 2019

Fingerprint

Dive into the research topics of '“We have to put the fire out first before we start rebuilding the house”: Practitioners’ experiences of supporting women with histories of substance use, interpersonal abuse and symptoms of post-traumatic stress disorder'. Together they form a unique fingerprint.

Cite this