Substance misuse and trauma have a very unique relationship. Studies have found that anywhere from 30-60% of substance abusing clients also suffer from a co-occurring diagnosis of Post-Traumatic Stress Disorder (PTSD). Clinicians at CMC are trained to assess and treat both of these issues using treatment approaches that have been proven in well-conducted studies to be effective.

While most people in their lives experience some degree of trauma, not everyone goes on to develop PTSD. Many people naturally recover from a traumatic experience, while others continue to have trouble related to trauma, and continue to experience symptoms of avoidance and anxiety.

Avoidance of trauma reminders (either through behaviors like avoiding triggers or by using substances) has a powerful short term immediate pay off. The anxiety is reduced in the moment, however, the long term consequences of avoiding trauma reminders can be significant. First, the world can become a very constricted and small place. Isolation, poor overall functioning at work and in relationships, and other problems like depression and anxiety can be the outcome of untreated PTSD symptoms. Second, using substances to manage trauma-related symptoms can add a host of other problems that can ultimately result in physical and emotional dependence on drugs and alcohol.

At CMC we believe it is crucial that clients have the option to address their substance use issues, while at the same time treating any unresolved PTSD symptoms. Often these symptoms are the drivers behind substance use choices and can often lead to relapse. To that end we use evidence-based treatments such as Prolonged Exposure (PE) and Skills Training in Affect and Interpersonal Regulation (STAIR) to treat traumatic disorders.

PTSD does not fade with time and can have a terrible impact on your ability to cope with and enjoy life. PTSD is, however, highly treatable. There are skills you can learn to manage your anxiety. Life does not have to be fear-based or small and constricted. You have already survived, let’s help you thrive.


How we can help

Prolonged Exposure (PE) is a time-limited, evidenced based treatment that aims to reduce your anxiety and improve your life. Treatment consists of approximately 8-15, 90 minute sessions, involving psychoeducation, breathing retraining, ongoing out-of-session practice, and in vivo and imaginal exposure. PE will help you to stop avoiding trauma reminders and will help you approach the things that scare you. PE does this in two ways: PE utilizes in vivo and imaginal exposure to reduce anxiety and distress related to trauma reminders and the traumatic memory. In vivo exposure (both in and out of session), will help you to gain experience confronting situations and memories you have previously worked to avoid. You can learn that you can actually tolerate the situations and the feelings you experience, and nothing bad actually happens to you. In fact, the more you confront these situations, your anxiety will decrease, a process called habituation. Further, through confronting these situations and learning that they are not dangerous, you will gain a new sense of competence and confidence in your life. Secondly, through imaginal exposure, (repeatedly revisiting the traumatic memory) in session, you will come to realize that your trauma was a specific event occurring in a specific time and place. This realization will help change any beliefs that you have that the world is a dangerous place and that you are incompetent to deal with it. In addition, you can learn that you can tolerate the anxiety you experience when remembering the traumatic memory and that this anxiety, with repetition, will decrease. You will also gain new perspective on the memory and learn that although the memories can be very scary, the memories are not dangerous.


Skills Training in Affect Regulation (STAIR) is an evidence based, time limited treatment, which also addresses PTSD and complex trauma. STAIR focuses on teaching people skills, which a traumatized individual might not have learned due to early traumatic experiences, or skills which may have diminished due to prolonged, or chronic trauma in later life. STAIR is a two part treatment, each phase consisting of approximately 8 sessions. The first phase of treatment focuses on learning skills for handling negative feelings and managing distress, and developing emotional awareness. Phase 1 also prepares you to work effectively in the more emotionally intense Phase II, which involves discussion and analysis of painful memories of childhood trauma. The goal of Phase II, or Narrative Story Telling (NST), is to organize your memories of trauma and resolve your feelings about them, so that you are able to control the memories rather than the memories’ controlling you. In addition, the process of describing your past is a means by which you will be able to identify beliefs about yourself, and patterns of relating that might have been adaptive in abuse circumstances, but no longer are adaptive in current relationships. The skills training from Phase I will help you leave behind old patterns of functioning and develop interpersonal behaviors and emotion management strategies that are consistent with your current life goals. We offer both group and individual STAIR services.