Study protocol: implementing and evaluating a trauma-informed model of care in residential youth treatment for substance use disorders

IntroductionComorbidity between Substance Use Disorders and trauma/post-traumatic stress disorder (PTSD) is common, particularly within residential treatment services. Comorbidity is associated with poorer treatment retention and treatment outcomes. Integrated treatment approaches are increasingly recommended but are still under examined in residential treatment services. This study will implement and evaluate a novel model of trauma-informed care (TIC) in a youth (18–35 years) residential substance use treatment service.Methods and analysisA single-armed, phase 1 implementation trial will be conducted in one residential treatment service. The model, co-developed with staff, incorporates: (i) workforce development in TIC through staff training and clinical supervision; adaptions to the service (ii) policies, procedures, and physical settings and (iii) treatment program adaptions (in delivery style and content) to be more trauma-informed; (iv) client screening and feedback for trauma and PTSD at service entry; and (v) the provision of support, referral and/or trauma-focused therapy to those with PTSD. Service outcomes will include adherence to the TIC model and client treatment completion. Client substance use and mental health measures will be collected at service entry, and 1-, 3-, 6- and 12-months follow up. Staff outcomes, including workplace satisfaction, burnout, and fatigue, as well as perceptions and confidence in delivering TIC will be collected at baseline, and at 3-, 6-, 12- and 18-months following training in the model. The sustainability of the delivery of the TIC model of care will be evaluated for 12 months using service and staff outcomes.Ethics and disseminationThe study has received ethical approval by the University of Queensland (Approval number: 2020000949). The results will be disseminated through publication in a peer-reviewed scientific journal, presentations at scientific conferences, and distributed via a report and presentations to the partner organization.Clinical trial registration: ACTRN12621000492853

Mental health outcomes following a large-scale potentially traumatic event involving police officers and civilian staff of the Queensland Police Service

A large-scale potentially traumatic event (PTE) poses considerable mental health risks for police services. There is limited literature detailing the mental health outcomes following large-scale PTEs. This study examined the mental health outcomes amongst Queensland Police Service (QPS) staff following a large-scale PTE. Two hundred and sixteen Australian police officers and support staff involved in the response to a natural disaster completed a clinical interview and measures of psychological distress (Kessler 10) and post-traumatic stress (PCL-C) 4 weeks post-deployment to the incident. The results showed that approximately 24% of the participants had elevated levels of general distress, while 13% had clinical levels of PTSD symptoms. Age was associated with the severity of PTSD symptoms but not general distress. Civilian staff reported significantly higher symptoms of general distress and PTSD than police officers. Females reported significantly higher symptoms of psychological distress than males; however, no differences were observed for symptoms of post-traumatic stress. Finally, the K10 had strong convergent validity with clinical levels of PTSD as measured by the PCL-C indicating that the K10 may be a useful general screening measure of both general distress and PTSD symptoms when brevity is needed in a large-scale PTE mental health screening measure

Memory Reconsolidation Therapy for Police Officers with Post-traumatic Stress Disorder

Police officers are frequently exposed to traumatic events and therefore are at elevated risk of developing post-traumatic stress disorder (PTSD) and other mental health conditions. While evidence-based treatments for PTSD such as prolonged exposure therapy demonstrate effectiveness, residual symptoms and relapse remain problematic outcomes. Improvements in outcomes may be enhanced by modifying psychotherapy processes based upon recent neuroscientific findings. The present study explored incorporating memory reconsolidation principles into evidence-based exposure therapy for PTSD to create memory reconsolidation therapy (MRT). MRT incorporates memory recall followed by a wait period to make memories liable for modification. Using a case series design, three police officers diagnosed with PTSD participated in a maximum of twelve 90-min sessions of MRT and recorded weekly self-report measures of trauma symptoms and psychological distress. Results indicated participants experienced significantly reduced psychological distress with gains maintained over a 3-month follow-up. A significant reliable reduction in trauma symptoms by post-therapy was identified in two of the three cases with the third narrowly missing the clinically significant cut-off. These significant changes were maintained over the 3-month follow-up in one participant, while the maintenance of these improvements in trauma symptoms approached significance in the other two participants. These findings provide preliminary evidence to justify larger future studies to test the efficacy of MRT with police officers experiencing PTSD.</p

Data_Sheet_1_Study protocol: implementing and evaluating a trauma-informed model of care in residential youth treatment for substance use disorders.PDF

IntroductionComorbidity between Substance Use Disorders and trauma/post-traumatic stress disorder (PTSD) is common, particularly within residential treatment services. Comorbidity is associated with poorer treatment retention and treatment outcomes. Integrated treatment approaches are increasingly recommended but are still under examined in residential treatment services. This study will implement and evaluate a novel model of trauma-informed care (TIC) in a youth (18–35 years) residential substance use treatment service.Methods and analysisA single-armed, phase 1 implementation trial will be conducted in one residential treatment service. The model, co-developed with staff, incorporates: (i) workforce development in TIC through staff training and clinical supervision; adaptions to the service (ii) policies, procedures, and physical settings and (iii) treatment program adaptions (in delivery style and content) to be more trauma-informed; (iv) client screening and feedback for trauma and PTSD at service entry; and (v) the provision of support, referral and/or trauma-focused therapy to those with PTSD. Service outcomes will include adherence to the TIC model and client treatment completion. Client substance use and mental health measures will be collected at service entry, and 1-, 3-, 6- and 12-months follow up. Staff outcomes, including workplace satisfaction, burnout, and fatigue, as well as perceptions and confidence in delivering TIC will be collected at baseline, and at 3-, 6-, 12- and 18-months following training in the model. The sustainability of the delivery of the TIC model of care will be evaluated for 12 months using service and staff outcomes.Ethics and disseminationThe study has received ethical approval by the University of Queensland (Approval number: 2020000949). The results will be disseminated through publication in a peer-reviewed scientific journal, presentations at scientific conferences, and distributed via a report and presentations to the partner organization.Clinical trial registration: ACTRN12621000492853.</p

Table_1_Study protocol: implementing and evaluating a trauma-informed model of care in residential youth treatment for substance use disorders.doc

IntroductionComorbidity between Substance Use Disorders and trauma/post-traumatic stress disorder (PTSD) is common, particularly within residential treatment services. Comorbidity is associated with poorer treatment retention and treatment outcomes. Integrated treatment approaches are increasingly recommended but are still under examined in residential treatment services. This study will implement and evaluate a novel model of trauma-informed care (TIC) in a youth (18–35 years) residential substance use treatment service.Methods and analysisA single-armed, phase 1 implementation trial will be conducted in one residential treatment service. The model, co-developed with staff, incorporates: (i) workforce development in TIC through staff training and clinical supervision; adaptions to the service (ii) policies, procedures, and physical settings and (iii) treatment program adaptions (in delivery style and content) to be more trauma-informed; (iv) client screening and feedback for trauma and PTSD at service entry; and (v) the provision of support, referral and/or trauma-focused therapy to those with PTSD. Service outcomes will include adherence to the TIC model and client treatment completion. Client substance use and mental health measures will be collected at service entry, and 1-, 3-, 6- and 12-months follow up. Staff outcomes, including workplace satisfaction, burnout, and fatigue, as well as perceptions and confidence in delivering TIC will be collected at baseline, and at 3-, 6-, 12- and 18-months following training in the model. The sustainability of the delivery of the TIC model of care will be evaluated for 12 months using service and staff outcomes.Ethics and disseminationThe study has received ethical approval by the University of Queensland (Approval number: 2020000949). The results will be disseminated through publication in a peer-reviewed scientific journal, presentations at scientific conferences, and distributed via a report and presentations to the partner organization.Clinical trial registration: ACTRN12621000492853.</p