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“This well-written book gives practical and valuable guidance to help clinicians at all levels in treating individuals suffering from trauma-related sequalae and substance use disorders. The book addresses many of the critical decision points and dilemmas that come up during the treatment of this complex patient population.”

—Kathleen Brady, MD, PhD, Distinguished University Professor, Medical University of South Carolina; Director, South Carolina Clinical and Translational Research Institute


“This important and much-needed book demonstrates how working concurrently on trauma and addiction can be synergistic, since each impacts the other. Based on their extensive clinical experience and research, the authors provide a state-of-the-art model for flexibly applying evidence-based strategies according to the needs, motivation, and preferences of the client. The book has an inviting tone and includes helpful case examples to illustrate major issues. It emphasizes a harm reduction approach as an alternative to an abstinence-only approach. A 'must read.'”

—Christine A. Courtois, PhD, ABPP, private practice (retired), Washington, DC; consultant and trainer, trauma psychology and treatment, Bethany Beach, Delaware


“Hien and Litt provide expert guidance for clinicians who wish to expand their proficiency in treating complex, co-occurring problems encountered in the real world of clinical practice. The book discusses the developmental trajectories of people with both trauma and substance use issues of varying levels of severity, and illustrates how these experiences can interrelate through the lifespan. It describes ways to integrate a range of evidence-based tools and treatments to help patients advance toward better health and well-being. The authors' approach is person centered and non-stigmatizing.”

—Shelly F. Greenfield, MD, MPH, Kristine M. Trustey Chair in Psychiatry and Chief Academic Officer, McLean Hospital; Professor of Psychiatry, Harvard Medical School


“This unique, comprehensive, clinically savvy book will be required reading for practitioners and trainees, whether they already have experience in this complex and challenging area or are navigating it for the first time. Written in a graceful conversational style, the book draws together several decades of clinical and research work on recovery from co-occurring traumatic stress and substance misuse. The case studies woven throughout offer therapeutic insights and cautions that are crucial for engaging with and safely and effectively guiding clients.”

—Julian D. Ford, PhD, ABPP, Department of Psychiatry, University of Connecticut Health Center

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Table of Contents

Preface

I. Integrative Conceptualization

1. Illustrative Cases

2. The Need for Integrative Care

II. Assessment and Treatment

3. Assessment and Formulation

4. Therapeutic Decisions: Finding What Works

5. The Treatment Landscape, Part I: Interventions That Target Traumatic Stress

6. The Treatment Landscape, Part II: Emotion Dysregulation, Substance Misuse, and Integrated Interventions

7. Pharmacological Interventions and New Directions

III. Clinical Considerations

8. Approaches and Challenges in Therapeutic Engagement

9. Relational and Countertransferential Concerns

10. Collaborating with a Team

11. Family Involvement and Parenting

A Final Note

References

Index

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About the Authors

Denise Hien, PhD, ABPP, is Senior Vice Provost of Research; Director and Helen E. Chaney Endowed Chair in Alcohol Studies in the Center of Alcohol and Substance Use Studies; and Distinguished Professor in the Graduate School of Applied and Professional Psychology at Rutgers, The State University of New Jersey. Considered a leader in the field since the 1990s, Dr. Hien has contributed to the evidence base on treatment of individuals with trauma-related psychiatric disorders and addiction through her research in community-based substance use treatment settings. She is board-certified in clinical psychology and serves on numerous national scientific advisory boards. She is the recipient of many honors, among them the inaugural Mary Jean Kreek Award for Underserved Populations from the College on Problems of Drug Dependence in 2023.

• Author's website

Lisa Caren Litt, PhD, a recognized expert in the integrated treatment of traumatic stress and substance misuse, is on the Clinical Faculty of the Department of Psychology at The New School for Social Research, where she oversees the Concentration in Mental Health and Substance Abuse Counseling. Dr. Litt is an adjunct faculty member at the Icahn School of Medicine at Mount Sinai, Adelphi University, and Teachers College, Columbia University. She is a member and past president of the Executive Committee of the New York State Psychological Association Division on Addictions and cochair of the Board of Directors of Moderation Management. She has been a consultant, trainer, and supervisor for behavioral intervention studies for posttraumatic stress disorder and substance misuse, and has a clinical psychology practice in New York City.

• Author's website

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Audience

Clinical psychologists, psychiatrists, clinical social workers, mental health and addictions counselors, and psychiatric nurses.

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Course Use

May serve as a supplemental text in graduate-level courses.