Implementing Prolonged Exposure Therapy in a Community Substance Use Treatment Program: A Qualitative Study

IF 2.9 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review Pub Date : 2026-08-26 DOI:10.1111/dar.70239

Steven Curto, Tasha Bulgin, Jordan A. Gette, Margaret Swarbrick, Angela Gonnella, Denise Hien, Sonya B. Norman, Shannon M. Kehle-Forbes

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引用次数: 0

Abstract

Introduction

Post-traumatic stress disorder (PTSD) commonly co-occurs with substance use disorders (SUD), yet few community-based SUD programs incorporate evidence-based trauma-focused. Prolonged exposure (PE), including its massed format (M-PE) with session frequency of 3–4 times per week, is a gold standard intervention for PTSD; however, concerns about client readiness, logistical demands and relapse risk have limited its adoption within SUD settings. This study examined staff perspectives on the feasibility and acceptability of integrating M-PE into a community-based SUD program.

Methods

Prior to launching a Hybrid Type 1 effectiveness–implementation trial (Project COMET), we conducted semi-structured virtual interviews with 15 community clinic staff: providers (n = 8), administrators (n = 2) and peer specialists (n = 5). Interviews were recorded, transcribed and analysed using a rapid qualitative analysis framework with matrix techniques to compare themes across roles.

Results

Four overarching themes captured staff perspectives on integrating M-PE: (Theme 1) Prior Knowledge and Experiences: Most staff were familiar with EMDR, while direct knowledge of PE/M-PE was limited. (Theme 2) Perceptions of M-PE: M-PE was widely viewed as a promising, structured intervention that fits the pacing and duration of SUD care. (Theme 3) Symptom Reduction and Client Impact: Staff anticipated improvements in PTSD and SUD symptoms through trauma-focused treatment. (Theme 4) Barriers and Constraints: Participants identified several potential implementation challenges, including logistical barriers and client readiness.

Discussion and Conclusions

Findings suggest that staff generally viewed M-PE favourably but emphasised the importance of ensuring client readiness and organisational support. Enhancing feasibility and long-term sustainability may require expanded psychoeducation, targeted provider training and flexible delivery models.

Trial Registration: ClinicalTrials.gov identifier: NCT06968832.

查看原文本刊更多论文

在社区物质使用治疗项目中实施长时间暴露疗法：一项定性研究。

引言：创伤后应激障碍（PTSD）通常与物质使用障碍（SUD）共同发生，但很少有以社区为基础的SUD项目纳入循证创伤为重点。延长暴露（PE），包括每周3-4次的大规模暴露（M-PE），是PTSD的金标准干预措施；然而，对客户准备情况、后勤需求和复发风险的担忧限制了其在SUD环境中的采用。本研究考察了员工对将M-PE纳入以社区为基础的SUD计划的可行性和可接受性的看法。方法：在启动混合型1有效性实施试验（COMET项目）之前，我们对15名社区诊所工作人员进行了半结构化的虚拟访谈：提供者（n = 8），管理人员（n = 2）和同行专家（n = 5）。访谈记录，转录和分析使用快速定性分析框架与矩阵技术，以比较不同角色的主题。结果：四个主要主题反映了员工对整合M-PE的看法：（主题1）先验知识和经验：大多数员工熟悉EMDR，而PE/M-PE的直接知识有限。（主题2）对M-PE的看法：M-PE被广泛认为是一种有前途的、结构化的干预措施，适合SUD护理的节奏和持续时间。（主题3）减轻症状和对患者的影响：工作人员期望通过以创伤为重点的治疗改善PTSD和SUD症状。（主题4）障碍和制约因素：与会者确定了几个潜在的实施挑战，包括后勤障碍和客户准备情况。讨论和结论：调查结果表明，员工普遍认为M-PE是有利的，但强调了确保客户准备和组织支持的重要性。提高可行性和长期可持续性可能需要扩大心理教育、有针对性的提供者培训和灵活的交付模式。试验注册：ClinicalTrials.gov标识符：NCT06968832。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Drug and alcohol review SUBSTANCE ABUSE-

CiteScore

4.80

自引率

10.50%

发文量

151

期刊介绍： Drug and Alcohol Review is an international meeting ground for the views, expertise and experience of all those involved in studying alcohol, tobacco and drug problems. Contributors to the Journal examine and report on alcohol and drug use from a wide range of clinical, biomedical, epidemiological, psychological and sociological perspectives. Drug and Alcohol Review particularly encourages the submission of papers which have a harm reduction perspective. However, all philosophies will find a place in the Journal: the principal criterion for publication of papers is their quality.