Saraiya T, Swarbrick M, Franklin L, et al. (2020). Perspectives on trauma and the design of a technology-based trauma-informed intervention for women receiving medications for addiction treatment in community-based settings. Journal of Substance Abuse Treatment. 112: 92-101. doi:10.1016/j.jsat.2020.01.011
Researchers recruited female clients with lifetime opioid use disorder (OUD) and symptoms of post-traumatic stress disorder (PTSD) (n = 11) and addiction treatment providers (n = 5) through study flyers at 2 community substance use clinics to participate in an investigation of barriers to trauma treatment and stakeholder perspectives on a prospective technology-based, trauma-informed intervention for women with OUD. Clients completed a quantitative assessment (substance use, trauma history, technology use) and a semi-structured interview. Providers (2 psychiatrists, 1 nurse, 1 social worker, 1 therapist) participated in a semi-structured interview. Analysis of study data revealed that, despite significant adulthood trauma exposure (3 traumatic events, on average), 42 PTSD symptoms, on average (64% met the diagnostic criteria for PTSD), and polysubstance use disorders beyond OUD (severe alcohol use disorder: 36.36%, severe cocaine use disorder: 27.27%), none of the women reported receiving evidenced-based treatment for trauma. Clients reported 2 main barriers to trauma treatment: distrust of providers and self-blame, while providers considered limited resources (i.e. time and provider training) the fundamental barrier to trauma treatment. Rather than reduce or replace in-person therapy, both clients and providers favored a trauma-informed smartphone adjunct to traditional treatment that could track and monitor symptoms while protecting patient privacy and confidentiality. Clients sought increased access to care and providers. Providers wanted the intervention to manage medication reminders, increase motivation, reward treatment progress, and reduce provider burden. Results suggest high interest in a trauma-informed technology adjunct for women with OUD among women in treatment and addiction providers.