Towards Gender-responsive, Trauma-informed Care for Substance ...

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Abstract

Trauma-informed care assumes an understanding of trauma is integrated in all aspects of service delivery and care. In women with substance use disorders (SUD) and post-traumatic stress disorder (PTSD), the disorders are treated simultaneously. Existing evidence in this sector points to the need for a gender-specific program approach to drug and alcohol disorders and health workers who have the knowledge, skills, expertise, and confidence to deliver these programs for women. The objective of this review is to identify characteristics associated with outcomes for SUD and PTSD and the experiences and needs of women in treatment contexts. A narrative synthesis of peer-reviewed literature from 2003 to 2013 was undertaken, with retrieved documents assessed using an inclusion/exclusion criterion and quality appraisal guided by critical assessment tools. Concepts were analysed thematically. Eleven papers were found that related to the topic under study. This review found that trauma-informed care models can lead to reduced alcohol and drug severity symptoms, improved abstinence rates, and reduced PTSD symptoms. However, a trauma-informed approach may be the most beneficial for women with severe SUD and PTSD symptoms. Trauma-informed care appears to be a promising treatment for women with SUD and PTSD. However, this appears to be mediated by client baseline characteristics and treatment program composition. This highlights the need for proper baseline assessment and flexible treatment programming delivered by a well-supported workforce.