Over the past 20 years, there has been a growing understanding of the impact of traumatization on the individuals who have these types of experiences. Through this knowledge growth has come an awareness that these individuals seek mental health and substance abuse treatment services at a greater frequency than those who have not experienced trauma. Those with a posttraumatic stress disorder diagnosis are five times more likely to be seen in a substance use disorder treatment program than those without this diagnosis. As a result, the Substance Abuse Mental Health Services Administration (SAMHSA) has focused on a trauma-informed care (TIC) model for working with this population. TIC promotes the importance of managing symptoms from a strengths-based approach, minimizing the retraumatization of the individual, and identifying and offering supports that are trauma informed. It is not necessary that everyone who comes in contact with a survivor of trauma be able to provide treatment that assists in resolution of the trauma, but everyone should have sufficient knowledge and skills to be able to identify and respond to the issues and not retraumatize these individuals.

There are many resources available. A quick Internet search returns over a dozen pages of links. Not all are credible. Check the following top 10, choose your favorite search engine, and go prepared to vet your results.

https://www.hazeldenbettyford.org/education/bcr/addiction-research/trauma-inform

TIC FOR SUBSTANCE ABUSE COUNSELING

Although the top link returned in the search, initially, Hazelden might appear to be a for-profit offering trying to sell you on treatment or to get a donation. In this case, we have a link to the education section of the Web site and the Butler Center for Research funded by Hazelden. The stated purpose of the center is to conduct research, collaborate with other researchers, and communicate the scientific findings within the organization and publically. The accuracy, authority, and objectivity are supported by the Butler Center for Research, not Hazelden, and the credentials of the author of the document. The document is dated 2018 and can be downloaded without additional software. The page has active links to major social media venues. As the title promises, the document covers the prevalence of co-occurring trauma and addiction, explains what TIC is, and gives suggestions on how to implement this approach. This directed at professionals and the public.

http://www.traumainformedcareproject.org/resources/SAMHSA%20TIC.pdf

Substance Abuse and Mental Health Services Administration. (2014). SAMHSA's concept of trauma and guidance for a trauma-informed approach. HHS Publication no. (sma) xx-xxxx. Rockville, MD: Author.

Before the concept of a trauma-informed approach in behavioral health care, there was a workgroup assigned to look at the impact of trauma and develop a concept for introducing this component into the delivery of care. This document explores the work done and outlines the steps taken as experts collected and blended research, professional practice, and survivor knowledge to put together a comprehensive overview of the concept of trauma and TIC. The document is accurate, authoritative, and objective. Although published in 2014, it is still current and available at the link above. This is appropriate for all audiences.

https://www.samhsa.gov/nctic

https://www.samhsa.gov/nctic/resources

https://www.samhsa.gov/nctic/trauma-interventions

The Web site for the SAMHSA hosts site of the National Center for Trauma Informed Care. This site assists in the implementation of the abovementioned concept paper. The pages devoted to the National Center for Trauma Informed Care cover every aspect of the topic from what it is to how you can implement it including links to resources, training, and technical assistance. The accuracy, authority, and objectivity of this information are attested to by federal agencies. The home page is current as of the fall of 2017. The resources and intervention pages are as of Spring 2018. All of the links are active. In addition, you can click on the cover of TIP 57: Trauma-Informed Care in Behavioral Health Services that opens the store page for the TIP where electronic copies can be downloaded. Additional associated resources are also available there. The contact information for calling, mailing, or emailing is included on the side of each page as are links for the various social media venues for sharing the information. Everyone can access and use this information.

https://www.samhsa.gov/samhsaNewsLetter/Volume_22_Number_2/trauma_tip/

This Spring 2014 issue of the SAMHSA News focused on announcing the publication of TIP 57. Although now 4 years old, TIP 57 is the definitive document on TIC. Although not currently available in print, this link will allow you to download an electronic copy. Additional links are included for sidebar articles, TIP resources, the SAMHSA blog, and the SAMHSA YouTube channel. Social media links are at the top and bottom of the page for easy access and sharing. Everyone can access and use this information.

https://www.ncbi.nlm.nih.gov/books/NBK207201/

Staying with access to TIP 57, this link to the National Center for Biotechnical Information at the U.S. National Library of Medicine gives several options for accessing the TIP. It is available for electronic download, a link for ordering print copies, and a list of contents that are all active links to each item in the contents. Users can select discrete portions to be downloaded and printed. The page also contains links to additional resources and social media. Clinicians might be most interested in the section download option.

https://www.ashwoodrecovery.com/blog/trauma-informed-care-important-addiction-tr

Blogs can be a credible source of information. One example is the previously mentioned SAMHSA blog. It is necessary to determine the original sourcing of the information contained in the blog. In this link, the Ashwood Recovery at Northpoint blog from April 2017 asks, What is Trauma-Informed Care and Is It Important During Addiction Treatment. Although not referenced formally, much of what is presented is attributed to the original source. Accuracy, authority, and objectivity can only be guessed at. The blog is current, but the content is undated. Social media links are included. There are several ways to contact Ashwood Recovery, and there is even a large Contact Us button that stays at the left bottom of page whether you scroll up or down. Although the content is appropriate for everyone, it appears directed toward potential patients and their family members.

https://brickelandassociates.com/trauma-informed-addiction-recovery/

Another example of a blog is this one posted by Brickel and Associates (2016). It appears to be intended for clients and potential clients of the therapy group. There is very little information on TIC. It appears to be more of a self-care blog than anything else. It has no attribution, authority, or objectivity. Their clients might find it interesting. The home page says the site supports positive change. It appears anyone can sign up to "get their best ideas by email," and the entire history of blog submission can be read by scrolling down from the current one. As it is not evidence based and the resources shared are dated to as far back as 1992, it has no value for professionals.

https://www.lakeviewhealth.com/treatment/integrative-health/trauma-informed-care

The Lakeview Health Web site is another example of how educational materials can be presented to the public. In this case, the site is not credible. The focus is on educating to advertize and increase interest in the services this treatment center provides. There is very little that is actually about TIC. What there is has no attribution. The remainder of the page talks about how this provider uses TIC approaches, has multiple links for signing up for information on treatment, displays the number with the exhortation to call, and has a big Chat Now button. Not a good source of information.

http://journals.iupui.edu/index.php/advancesinsocialwork/article/view/21312

Goodman, R. (2017). Contemporary trauma theory and trauma-informed care in substance use disorders: A conceptual model for integrating coping and resilience. Advances in Social Work, 18(1), 186-201. doi:10.18060/21312

This article from Goodman (2017), available in PDF format at the above Web link, provides a complete overview of the effects of trauma, the correlation between childhood trauma and a substance use disorder, and the resulting consequences. Coping and resilience have been identified as factors that play a role in mitigating these consequences. The author provides us with a core model for integrating these approaches into treatment. As an article from a peer-reviewed professional journal, it meets criteria for accuracy, authority, and objectivity. The text is available at no cost to the reader. Although this is written with social work professionals in mind, it would be easy for laypersons to read and understand. The social work implications can be easily translated to other professional disciplines.

https://www.youtube.com/watch?v=uE3xNWrixh8

(Trauma-Informed Care for Families Affected by Substance Use)

If you don't want to read, remember the SAMHSA YouTube channel and all the other You Tube offerings. The link offered here is to a video presentation from the Atlantic Technology Transfer Center. Anyone can access these educational offerings. There only needs to be a device and Internet access. Check the source attribution. Government agencies, institutions of higher learning, and many organizations will provide accurate and objective information. The audience can be anyone-public, student, and professional. Present them as examples in lectures or give them for homework; just make sure the dates are recent.

So now, go try out these links, do your own Internet check, or drop into YouTube and find out what is being said about a trauma-informed approach to behavioral health treatment.