Polcin Douglas L, Nayak Madhabika B, Blacksher Susan
Alcohol Research Group, Public Health Institute, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608-1010, Extension 277.
California Association of Addiction Recovery Resources, 2921 Fulton Ave.P.O. Box 214127, Sacramento, CA 95821.
J Drug Addict Educ Erad. 2008 Jan 1;4(3-4):221-237.
A large majority of women entering addiction treatment present significant symptoms of trauma related to physical or sexual abuse. Despite research indicating that trauma interventions are integral to women's successful recovery from addiction, many programs do not adequately address violence-related trauma. This chapter provides a review of the literature on trauma among women with addictive disorders and several manual based interventions developed to address co-occurring addiction and trauma-related disorders. One intervention, "Beyond Trauma," which has become increasingly popular among community based programs is described in detail. Beyond Trauma appears to have several advantages over other therapies for treating trauma and addiction in women, including 1) a theoretical foundation that draws on relational theory as a guide to the intervention, 2) a broad based approach that can be utilized by a variety of professional and paraprofessional staff members, 3) a focus that goes beyond treating women with a formal diagnosis of post traumatic stress disorder to include treatment for an array of symptoms and problems associated with trauma, and 4) gender-appropriate use of expressive arts in its curriculum. The chapter also discusses treatment program environment factors that may be critically important to treatment outcome for women: 1) whether the program is gender specific, 2) the degree of emphasis on peer involvement in recovery, 3) program recognition of the value of knowledge-based recovery experience, 4) program facilitation of cohesion, 5) the empowerment of clients in decisions affecting the program and 6) skills training relevant to managing moods, relationships and a variety of problems that women face during recovery. Possible mechanisms of change for Beyond Trauma are explored with particular emphasis on the variety of ways the intervention attempts to impact problem areas experienced by women (e.g., mental health functioning self esteem and social support). Recommendations for future research in the treatment of trauma and addiction-related disorders in women are outlined.
进入成瘾治疗的绝大多数女性都表现出与身体或性虐待相关的严重创伤症状。尽管研究表明创伤干预对于女性从成瘾中成功康复至关重要，但许多项目并未充分解决与暴力相关的创伤问题。本章回顾了有关成瘾性障碍女性创伤的文献，以及为解决同时存在的成瘾和创伤相关障碍而开发的几种基于手册的干预措施。详细描述了一种名为“超越创伤”的干预措施，它在社区项目中越来越受欢迎。与其他治疗女性创伤和成瘾的疗法相比，“超越创伤”似乎有几个优点，包括：1）以关系理论为干预指导的理论基础；2）一种广泛适用的方法，可供各种专业和准专业工作人员使用；3）不仅关注对有创伤后应激障碍正式诊断的女性进行治疗，还包括对与创伤相关的一系列症状和问题进行治疗；4）在其课程中适当运用了适合性别的表达性艺术。本章还讨论了对女性治疗结果可能至关重要的治疗项目环境因素：1）项目是否针对性别；2）对同伴参与康复的重视程度；3）项目对基于知识的康复经验价值的认可；4）项目促进凝聚力的情况；5）赋予客户在影响项目的决策中的权力；6）与管理情绪、人际关系以及女性在康复过程中面临的各种问题相关的技能培训。探讨了“超越创伤”可能的改变机制，特别强调了该干预措施试图影响女性所经历问题领域的多种方式（例如，心理健康功能、自尊和社会支持）。概述了未来在女性创伤和成瘾相关障碍治疗研究方面的建议。
