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

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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

1. Treatment must be developmentally informed.
2. Treatment must directly address the social
   ecology.
3. Treatment must be compatible with systems of
   care.
4. 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