title: Treatment challenges associated with comorbid substance use and posttraumatic stress disorder: clinicians' perspectives.
abstract: A significant proportion of individuals with substance use disorders (SUDs) meet criteria for comorbid posttraumatic stress disorder (PTSD). This comorbidity confers a more complicated clinical presentation that carries with it formidable treatment challenges for practitioners. The current study examined sources of difficulty and gratification among clinicians (N = 423) from four national organizations who completed an anonymous questionnaire. As expected, the findings revealed that comorbid SUD/PTSD was rated as significantly more difficult to treat than either disorder alone. The most common challenges associated with treating SUD/PTSD patients included knowing how to best prioritize and integrate treatment components, patient self-destructiveness and severe symptomatology, and helping patients abstain from substance use. The findings increase understanding of SUD/PTSD treatment challenges, and may be useful for enhancing therapist training programs, supervision effectiveness, and designing optimal SUD/PTSD interventions.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina 29425, USA. backs@musc.edu
authors.forename: Sudie E
authors.initials: SE
authors.lastname: Back
authors.forename: Angela E
authors.initials: AE
authors.lastname: Waldrop
authors.forename: Kathleen T
authors.initials: KT
authors.lastname: Brady
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D017831:Diagnosis, Dual (Psychiatry); D004644:Emotions; D005260:Female; D019538:Health Care Surveys; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D005791:Patient Care; D016728:Self-Injurious Behavior / Q000150:complications; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000150:complications* / Q000628:therapy*; D019966:Substance-Related Disorders / Q000150:complications* / Q000628:therapy*; D016896:Treatment Outcome