Institute for Health Equity and Social Justice Research, Northeastern University, Boston, MA, USA.
VISN 1 Mental Illness Research, Education and Clinical Center, ENRM VA Medical Center, USA.
J Dual Diagn. 2020 Jul-Sep;16(3):347-356. doi: 10.1080/15504263.2020.1744786. Epub 2020 Apr 14.
: This case series describes and illustrates the effective use of a trauma-informed approach, GLAPE, to provide drug screens for individuals in substance use treatment programs. The GLAPE approach recognizes that individuals who have experienced traumatic events and are recovering from substance use difficulties may also face unique challenges when engaging in mental health treatment. The nature of drug screening procedures in practice may feel invasive and triggering for clients with trauma histories. Finding ways to decrease barriers to treatment and increase engagement and retention are important components of effective substance use treatment. This case series involved three veteran cisgender men with posttraumatic stress disorder (PTSD) and co-occurring substance use conditions in an outpatient addiction recovery program in a Veterans' hospital. The cases illustrate how recovery can be aided by trauma-informed approaches for urine drug screens. The treatment team evaluated various monitoring modalities and collaborated with each client to form a treatment plan that implemented the GLAPE approach to bolster their recovery. The GLAPE approach includes five components: detailed instructions prior to the urine screen procedure, to and eliciting questions and concerns of the client, options and exhibiting flexibility in the procedure to accommodate the needs of the individual client, giving to the client to voice concerns at any point during the procedure, and the process in collaboration with the client, including what could be improved for next time. Use of the GLAPE approach effectively helped to engage and retain military veterans with co-occurring PTSD and substance use disorder within a trauma informed outpatient program. Preliminary evidence from three cases provides that this approach may be useful for use in substance use treatment with clients who have trauma histories. Given widespread use of observed urine drug screens in substance use treatment programs, and prominent co-occurrence of substance use disorder and PTSD, it is essential that staff approach this procedure in a trauma-informed way. This case series illustrates an approach that can improve client experience, aid clients in treatment engagement, and assist staff in the provision of effective care.
这一系列案例描述并说明了使用创伤知情方法（GLAPE）为接受药物使用治疗的个体提供药物筛查的有效性。GLAPE 方法认识到，经历过创伤事件并正在从药物使用困难中康复的个体在接受心理健康治疗时可能还面临独特的挑战。药物筛查程序在实践中的性质可能会让有创伤史的客户感到侵犯和触发。减少治疗障碍、提高参与度和保留率是有效药物使用治疗的重要组成部分。 该案例系列涉及在退伍军人医院的门诊成瘾康复计划中，有三位经历过创伤后应激障碍（PTSD）和共病药物使用障碍的退伍军人男性。这些案例说明了如何通过创伤知情方法来辅助尿液药物筛查来促进康复。治疗团队评估了各种监测模式，并与每位客户合作制定治疗计划，实施 GLAPE 方法以加强他们的康复。GLAPE 方法包括五个组成部分： 在尿液筛查程序之前提供详细的说明， 在尿液筛查程序中倾听并询问客户的问题和关注点， 在程序中提供选项并表现出灵活性，以适应个体客户的需求， 让客户在程序的任何时候表达顾虑，以及 与客户合作完成程序，包括下次可以改进的地方。 使用 GLAPE 方法有效地帮助参与并留住了共病 PTSD 和物质使用障碍的退伍军人，使其在创伤知情的门诊项目中保持康复。来自三个案例的初步证据表明，该方法可能对有创伤史的客户的药物使用治疗有用。 鉴于观察性尿液药物筛查在药物使用治疗计划中的广泛应用，以及物质使用障碍和 PTSD 的高发共病率，工作人员必须以创伤知情的方式进行这种程序。本案例系列说明了一种可以改善客户体验、帮助客户参与治疗并协助工作人员提供有效护理的方法。
