In North America, substance abuse is a public health crisis with annual costs in the billions. Individuals suffer from substance use disorders for multiple years throughout their lifespan. This suggests that neither historical, community-based interventions, nor current, evidence-based behavioral modalities are successful in healing the causes of addiction. A growing corpus of research has established that traumatic early-childhood experiences and insecure attachments are both independent and interrelated risk factors for developing substance abuse disorders. An impressive literature is emerging exploring potential applications of attachment theory-informed intervention. There has yet to be widespread adoption of such techniques. By examining the scholarly literature, this paper synthesizes existing work on attachment theory in the treatment of substance use disorders. A clinical case application is provided to highlight the potential for attachment-informed therapy. Recommendations for using attachment-informed approaches in the treatment of substance use disorders with various groups are offered.
CONTEXT: Evidence from the COVID-19 crisis suggests that children and youth are more likely to be subjected to maltreatment and exposure to family violence, while experiencing limited access to the usual services that support vulnerable families and provide targeted services to meet their needs. The current global pandemic itself can also be experienced as a traumatic event. Trauma-informed care draws attention to the potential impacts, from the individual to the global, that myriad traumatic experiences can illicit and proposes using these understandings as foundational to the development and implementation of policy and practice. OBJECTIVE: The aim of this opinion paper is to offer insights to guide practices and policies during this unprecedented global crisis through a discussion of the Substance Abuse and Mental Health Services Administration (2014)’s six trauma-informed care principles: trustworthiness and transparency; safety; peer support; collaboration and mutuality; empowerment and choice; and cultural, historical and gender issues. FINDINGS: Specific recommendations based on these six principles and applied to the current situation are presented and discussed. These principles can serve both in the immediate crisis and as preventative measures against unforeseen future traumatic contexts. CONCLUSION: COVID-19 renews the imperative to maintain and strengthen trauma-informed practices and policies. We argue that never before has trauma-informed care been so important to promote the health and well-being of all and to protect our marginalized populations at greatest risk.
Human service professionals offering psychosocial services to people who have experienced intimate partner violence (IPV) report multiple impacts to their physical and psychological well-being. These impacts have been described and investigated through multiple concepts including vicarious trauma, secondary traumatic stress disorder, compassion fatigue, and posttraumatic stress disorder. This scoping review mapped the relevant empirical literature on this topic guided by the question: What has been found in the empirical, peer-reviewed, scholarly literature examining exposure to the aversive details of IPV among human service professionals? A total of 13 relevant empirical studies investigating the impacts of exposure to the aversive details of IPV and human service professionals were found. The results were charted, collated, and summarized. The results support previous research finding IPV human service professionals to be at elevated risk of harm as a result of their work. The impacts of IPV practice were predominantly described as challenging. Some research participants also reported having experienced positive growth and appreciation for their work despite exposure to traumatic events. Protective factors including workplace social support emerged. Implications for practice, training, and research are offered.
Context: Rates of traumatization among residential child welfare professionals are alarmingly high. The well-being of these professionals is associated both with their intention to stay in their jobs and outcomes of children in their care. Several risk factors threaten the well-being of child welfare professionals, including primary and secondary exposure to experiences with the potential to provoke posttraumatic stress reactions. Objectives: This manuscript details experiences empirically shown to have potential negative impacts on professional well-being, discusses why these impacts are of particular concern for residential childcare workers, and describes the types of organizational cultures and climates that appear to mitigate these negative impacts. Implications: Trauma-informed care at the organizational level is proposed both as a means to reduce harm to child-welfare professionals and promote the rehabilitation of children within the child welfare system.
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