Trauma Systems Therapy for Adolescent Substance Abuse

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Trauma Systems Therapy for Adolescent Substance
Abuse(TST-SA)

• Liza Suárez, Ph.D. Glenn Saxe, MD
• Center for Anxiety and Related Disorders
  Center for Medical and Refugee Trauma
• Boston University
  Boston Medical Center
• Jill Ehrenreich, Ph.D. David Barlow,
  Ph.D.
• Center for Anxiety and Related Disorders
• Boston University

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Need for Integrated Treatment Approaches

• Increased risk among adolescents
• Late identification and poor response to current
  treatment approaches
• Clinicians need training in more areas
• Multiple problems associated with SUD-PTSD
  comorbidity
• Involved with multiple service systems
• No current integrated approaches available for
  adolescents

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Goals of TST

• Treatment must be developmentally informed.
• Treatment must directly address the social
  ecology.
• Treatment must be compatible with systems of
  care.
• Treatment must be disseminate-able.

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TST in a Nutshell

• Interventions in TST are designed to work in two
  dimensions
• Strategies that operate through and in the social
  environment to promote change
• Strategies that enhance the individual's capacity
  to self-regulate.
• Specific TST interventions include home and
  community-based care, emotional regulation skills
  training, services advocacy, trauma processing,
  and psychopharmacology.

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Empirical support from TST Open Trial (Saxe,
Ellis, Fogler, Hansen, Sorkin, 2005)

• TST open trial (Saxe, Ellis, Fogler, Hansen,
  Sorkin, 2005)
• ? trauma symptoms, ? emotional and behavioral
  regulation
• More stable social environment
• Transitioning from more intensive to less
  intensive phases of treatment.
• TST controlled trial (preliminary findings)
• Reduced drop out rates (100 vs 10 retention
  after 3 months)
• Dissemination Ulster County Program Evaluation
• ? trauma symptoms, ? family stability
• ? hospitalization rates and length of hospital
  stay
• ? length for need of services

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Why Trauma Systems Therapy for Adolescent
Substance Abuse?

• Comprehensive and flexible treatment approach
• Dual focus on social environmental and emotional
  regulation interventions
• Engagement and the treatment alliance
• Help families navigate multiple systems of care

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TST-SA Components Added for the Adaptation of
TST for Adolescent Substance Abuse

• Motivational enhancement strategies
• Psychoeducation about substance abuse and its
  interaction with symptoms of traumatic stress.
• Behavior management strategies for parents
• Additional empirically supported substance abuse
  treatment components
• Teen and parent workbook
• Weekly assessment tools.

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Training opportunities

• A learning collaborative for TST-SA will take
  place in late October of 2006. For more
  information about this training, or TST-SA,
  contact Liza Suarez at lsuarez_at_bu.edu or
  617-353-9610
• For more information about Trauma Systems Therapy
  contact Glenn Saxe at Glenn.Saxe_at_bmc.org or
  617-414-7531