Trauma-Informed Care and Addiction Treatment

Learn how Compass Recovery uses trauma-informed care in its treatment programs in this article.

From the moment humans are born, their experiences shape how they perceive and interact with the world around them. Because our experiences impact us, severely disturbing events called trauma can have lasting adverse effects on one’s life. Trauma can include negative experiences such as poverty, violence, separation from a loved one, neglect, or physical or sexual abuse.

Trauma alters every area of a person’s world, from their physical well-being to their mental health and behavioral choices. Everyone is susceptible to trauma, and no one is immune.

What is Trauma?

According to the American Psychological Association (APA), trauma is “an emotional response to a terrible event like an accident, rape or natural disaster.” An individual doesn’t have to be the victim of a traumatic situation to experience trauma. Many people who are witnesses — or even perpetrators — can experience psychological trauma from an incident. For example, children who witness a shooting may not have been the victims, but they can still be negatively affected by the experience for years afterward.

Although the physical trauma from an event might heal, the emotional trauma can linger. Directly after a traumatic event, people typically feel denial or shock. As time progresses, one might experience flashbacks of the event, erratic mood swings, or even physical responses like nausea or high blood pressure. Although these trauma responses are typical, long-term effects can make life extremely challenging if left untreated and unresolved.

Principles of Trauma-Informed Care

Formed in 2005, the National Center for Trauma-Informed Care framed the evidence-based concept of trauma-informed care to recognize that trauma can have a powerful impact across a person’s lifetime. Through a trauma-informed approach to care, organizations can potentially improve a client’s health outcomes and treatment adherence. The six principles of TIC are:

• Safety
• Trustworthiness & transparency
• Peer support
• Collaboration & mutuality
• Empowerment & choice
• Cultural, historical & gender issues

Adopting a trauma-informed approach isn’t about checking through all six principles, but rather weaving them throughout care for a client and through every aspect of an organization. Trauma-informed care involves a holistic approach, taking into account every part of a client’s life, including their spiritual beliefs, family history, home environment, and economic status.

Types of Trauma

How people experience trauma and cope with it differs from person to person. Trauma can stem from any distressing event, but there are thirteen main types of trauma:

• Bullying
• Community Violence
• Complex Trauma
• Domestic Violence
• Early Childhood Trauma
• Medical Trauma
• Natural Disasters
• Neglect
• Physical Abuse
• Refugee and War Zone Trauma
• School Violence
• Sexual Abuse
• Traumatic Grief

Adverse Childhood Experiences (ACEs)

According to the CDC, ACEs are “potentially traumatic events that occur in childhood (0-17 years).” Childhood trauma can include experiences such as physical or sexual abuse, neglect, or the sudden loss of a close family member. About 61% of adults have had at least one type of ACE, while 1 out of 6 adults has had 4 or more ACEs in their childhood.

Studies show that ACEs are connected to a child’s future by negatively contributing to chronic illness, substance abuse, poor education, and work opportunities. Childhood trauma can also prevent children from forming healthy relationships in the future and can result in unstable work histories and financial struggles in adulthood due to their trauma response.

Trauma-Informed Care in Addiction Treatment

Consider the following statistics:

• About two-thirds of intravenous drug users experienced trauma as children.
• Individuals with an ACE score of 5 or more are 7-10 times more likely to develop substance abuse.
• About 75% of people receiving addiction treatment have a history of trauma.
• Over 30% of people receiving addiction treatment have a diagnosis of Post-Traumatic Stress Disorder (PTSD).

The link between psychological trauma and substance abuse runs both ways. Trauma increases the likelihood of high-risk behavior like substance use which results in substance use disorder (SUD). People who have been traumatized are more likely to develop substance abuse and are less able to cope with the trauma that stems from substance use. Addressing trauma alongside addiction treatment is vital for successful recovery.

Evidence-Based Models for Healing

Trauma research has led to the development of trauma-focused care models to treat SUD. These trauma therapy programs offer multiple avenues for treating emotional trauma and substance use at the same time:

ATRIUM

The Addictions and Trauma Recovery Integration Model (ATRIUM) relies on research evidence that trauma impacts body, mind, and spirit. By integrating relational treatment and incorporating trauma-focused therapy practices, ATRIUM holistically addresses all three levels, working in both peer/group settings or with therapists.

Helping Women Recover (HWC)

Based on Women’s Integrated Treatment (WIT), this model provides a gender-responsive and trauma approach to working with women in both group and individual settings. HWC consists of four modules: self, spirituality, relationships, and sexuality, which are essential to growth and healing.

Seeking Safety

This program helps both men and women develop coping skills necessary to overcome trauma and substance use, focusing on behavioral and thinking strategies to manage life challenges, prevent relapse, and recover from emotional trauma.

Trauma Recovery and Empowerment Model (TREM)

TREM is group-based treatment focused on trauma recovery for women with histories of sexual or physical abuse. It fosters positive coping skills and social support while addressing the consequences of violent victimization, helping trauma survivors overcome substance use disorders.

TRIADS

The TRIADS framework uses ACEs findings to identify strengths, screen, and provide trauma-informed interventions. It seeks a holistic understanding of a client’s personal and family history to manage mental health concerns and substance use effectively.

Avoiding Re-Traumatization

Trauma survivors often risk being retraumatized during therapy. Re-traumatization occurs when a trigger—such as a scent, area, sound, or word—reminds the survivor of the traumatic event. Trained counselors mitigate this risk by creating a safe, accepting environment that allows clients to explore emotions and identify potential triggers safely.

Integrating Trauma-Informed Care into Addiction Treatment

Successful addiction treatment recognizes the link between trauma and substance use disorder. Trauma-informed care ensures both clients and staff approach recovery with awareness, respect, and holistic strategies. Programs integrating trauma therapy programs, healing from trauma, addiction recovery support, and psychological trauma treatment provide the most effective environment for lasting wellness and recovery.

If you are experiencing a mental health crisis or need immediate support, please visit SAMHSA’s National Helpline or call 988 for the Suicide and Crisis Lifeline.