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Trialling exposure-based therapy for adolescent traumatic stress and substance use: Challenges and observations from a randomized controlled trial

Mills, Katherine ; Teesson, Maree ; Back, Sudie ; Barrett, Emma ; Cobham, Vanessa ; Bendall, Sarah ; Perrin, Sean LU orcid ; Brady, Kathleen and Ross, Joanne (2019) Trauma in Transition: Building Bridges p.63-63
Abstract
Background: For up to 50% of adolescents experiencing PTSD, the course of their illness is further complicated by co-occurring substance use. Despite this, evidence-based integrated treatment options for adolescents with this comorbidity remain sparse. To address this gap, we are conducting an RCT examining the efficacy of exposure-based therapy for co-occurring PTSD and substance use among adolescents. In this paper, we discuss some of the challenges associated with conducting an RCT in the population group and early observations from the trial. Method: A total of 100 adolescents aged 12–18 years will be recruited. Participants are randomized to receive up to 16 sessions of (i) the integrated exposure-based treatment (COPE-A) or (ii)... (More)
Background: For up to 50% of adolescents experiencing PTSD, the course of their illness is further complicated by co-occurring substance use. Despite this, evidence-based integrated treatment options for adolescents with this comorbidity remain sparse. To address this gap, we are conducting an RCT examining the efficacy of exposure-based therapy for co-occurring PTSD and substance use among adolescents. In this paper, we discuss some of the challenges associated with conducting an RCT in the population group and early observations from the trial. Method: A total of 100 adolescents aged 12–18 years will be recruited. Participants are randomized to receive up to 16 sessions of (i) the integrated exposure-based treatment (COPE-A) or (ii) supportive counselling (control). Blind interviews are conducted at baseline, 4- and 12-months. Substance use and PTSD are measured each therapy session. Results: To date, 20 people have been referred to the study with 17 screened for eligibility. A total of 13 were eligible to participate with nine consented and allocated to a condition. Challenges to trial execution include issues relating to the population group itself, involvement of parents/guardians and other health care providers, logistics, ethical and governance approvals, and resources. Discussion: Although there are significant challenges involved in conducting a trial such as this, they are by no means insurmountable. The study findings will improve our understanding of how to best treat PTSD and substance use during this critical develop-mental period. By intervening early in the trajectory ofthese disorders, it may be possible to prevent thesevere and long-lasting burden associated withcomorbidity across the lifespan. (Less)
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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to conference
publication status
published
subject
keywords
PTSD, Substance use, Adolescents, Treatment, CBT, Randomized controlled trial
pages
1 pages
conference name
Trauma in Transition: Building Bridges
conference location
Rotterdam, Netherlands
conference dates
2019-07-14 - 2019-07-16
project
Randomised controlled trial of an integrated cognitive-behavioural therapy for the treatment of co-occurring post traumatic stress disorder and substance use disorder in adolescents
language
English
LU publication?
yes
id
84be4da2-a9d0-481d-a9ae-cbc1e11f1dcd
alternative location
https://www.tandfonline.com/doi/pdf/10.1080/20008198.2019.1613834?needAccess=true
date added to LUP
2019-07-27 18:33:40
date last changed
2019-07-30 02:19:11
@misc{84be4da2-a9d0-481d-a9ae-cbc1e11f1dcd,
  abstract     = {{Background: For up to 50% of adolescents experiencing PTSD, the course of their illness is further complicated by co-occurring substance use. Despite this, evidence-based integrated treatment options for adolescents with this comorbidity remain sparse. To address this gap, we are conducting an RCT examining the efficacy of exposure-based therapy for co-occurring PTSD and substance use among adolescents. In this paper, we discuss some of the challenges associated with conducting an RCT in the population group and early observations from the trial. Method: A total of 100 adolescents aged 12–18 years will be recruited. Participants are randomized to receive up to 16 sessions of (i) the integrated exposure-based treatment (COPE-A) or (ii) supportive counselling (control). Blind interviews are conducted at baseline, 4- and 12-months. Substance use and PTSD are measured each therapy session. Results: To date, 20 people have been referred to the study with 17 screened for eligibility. A total of 13 were eligible to participate with nine consented and allocated to a condition. Challenges to trial execution include issues relating to the population group itself, involvement of parents/guardians and other health care providers, logistics, ethical and governance approvals, and resources. Discussion: Although there are significant challenges involved in conducting a trial such as this, they are by no means insurmountable. The study findings will improve our understanding of how to best treat PTSD and substance use during this critical develop-mental period. By intervening early in the trajectory ofthese disorders, it may be possible to prevent thesevere  and  long-lasting  burden  associated  withcomorbidity across the lifespan.}},
  author       = {{Mills, Katherine and Teesson, Maree and Back, Sudie and Barrett, Emma and Cobham, Vanessa and Bendall, Sarah and Perrin, Sean and Brady, Kathleen and Ross, Joanne}},
  keywords     = {{PTSD; Substance use; Adolescents; Treatment; CBT; Randomized controlled trial}},
  language     = {{eng}},
  month        = {{06}},
  pages        = {{63--63}},
  title        = {{Trialling exposure-based therapy for adolescent traumatic stress and substance use: Challenges and observations from a randomized controlled trial}},
  url          = {{https://www.tandfonline.com/doi/pdf/10.1080/20008198.2019.1613834?needAccess=true}},
  year         = {{2019}},
}