Exposure based therapy for post-traumatic stress disorder and substance use disorder among individuals with a history of sexual assault

Introduction and Aims: Sexual assault (SA) and post-traumatic
stress disorder (PTSD) are highly prevalent among individuals with
substance use disorder (SUD). Previous research has demonstrated
the effectiveness of exposure based therapies for treating individuals
with a history of SA experienced both in childhood and/or adulthood,
however, individuals with a SUD have typically been excluded from
these trials. This paper aims to present an analysis of treatment
outcomes for individuals who have experienced SA who received an
integrated SUD + PTSD treatment utilising exposure techniques.
Design and Methods: Data were collected as part of a randomised
controlled trial of an exposure based therapy for PTSD and SUD
called Concurrent Treatment with Prolonged Exposure. The 13
session intervention consists of psychoeducation, cognitive
behavioural therapy for SUD and PTSD, imaginal and in-vivo
exposure. Participants completed interviews at baseline, 6-weeks,
3- and 9-months follow-up.
Results: Of the 55 participants randomly allocated into the
treatment group, 25 had experienced childhood SA and 17 had
experienced SA in adulthood only. Thirty-seven participants started
the treatment and a median of 5 sessions were attended. Eight
participants completed all 13 sessions. Signifi cant reductions in
PTSD symptom severity were observed. Between-group comparisons
of end-of-treatment outcomes revealed no signifi cant differences
between individuals who had experienced SA in childhood versus
those who had experienced SA in adulthood only.
Discussion and Conclusions: These fi ndings suggest that
integrated exposure based therapies for PTSD and SUD may be
benefi cial for clients with a history of SA.