Description:

Cognitive Processing Therapy (CPT) is an evidence-informed cognitive behavioral treatment for PTSD that occurs over approximately 12 individual or group treatment sessions. Through CPT, clients learn about symptoms of PTSD, the connection between trauma-based thoughts and feelings, and how trauma affects their daily lives. CPT therapists engage clients to recognize and challenge unrealistic thoughts, referred to as “stuck points,” throughout the course of treatment. CPT is a gold-standard therapy for people who have experienced trauma, including interpersonal violence, sexual trauma, childhood abuse, and combat. CPT improves quality of life by reducing intrusions, avoidance, worsening cognition and mood, and hyperarousal.

Literature & Resources:

Links to Literature

• Andrews B, Brewin CR, Rose S. Gender, Social Support, and PTSD in Victims of Violent Crime. Journal of Traumatic Stress. 2003;16(4):421-427.

• Brownley JR, Fallot RD, Wolfson Berley R, Himelhoch SS. Trauma History in African-American Women Living with HIV: Effects on Psychiatric Symptom Severity and Religious Coping. AIDS Care. 2015;27(8):964-971.

• Chard KM. An Evaluation of Cognitive Processing Therapy for the Treatment of Posttraumatic Stress Disorder Related to Childhood Sexual Abuse. Journal of Consulting and Clinical Psychology. 2005;73(5):965-971.

• Galovski TE, Blain LM, Mott JM, Elwood L, Houle T. Manualized Therapy for PTSD: Flexing the Structure of Cognitive Processing Therapy. Journal of Consulting and Clinical Psychology. 2012;80(6):968-981.

• Gonzalez A, Locicero B, Mahaffey B, Fleming C, Harris J, Vujanovic AA. Internalized HIV Stigma and Mindfulness: Associations With PTSD Symptom Severity in Trauma-Exposed Adults With HIV/AIDS. Behavior Modification. 2016;40(1-2):144-163.

• Kalichman SC, Sikkema KJ, DiFonzo K, Luke W, Austin J. Emotional Adjustment in Survivors of Sexual Assault Living with HIV-AIDS. Journal of Traumatic Stress. 2002;15(4):289-296.

• Kessler RC, Sonnega A, Bromet E, Hughes M, Nelson CB. Posttraumatic Stress Disorder in the National Comorbidity Survey. Archives of General Psychiatry. 1995;52(12):1048-1060.

• McCann IL, Pearlman LA. Vicarious Traumatization: A Framework For Understanding the Psychological Effects of Working with Victims. Journal of Traumatic Stress. 1990; 3(1):131-149.

• Resick PA, Galovski TE, Uhlmansiek MO, Scher CD, Clum GA, Young-Xu Y. A Randomized Clinical Trial to Dismantle Components of Cognitive Processing Therapy for Posttraumatic Stress Disorder in Female Victims of Interpersonal Violence. Journal of Consulting and Clinical Psychology. 2008;76(2):243-258.

• Resick PA, Nishith P, Weaver TL, Astin MC, Feuer CA. A Comparison of Cognitive Processing Therapy with Prolonged Exposure and a Waiting Condition for the Treatment of Chronic Posttraumatic Stress Disorder in Female Rape Victims. Journal of Consulting and Clinical Psychology. 2002;70(4):867-879.

• Resick PA, Wachen JS, Dondanville KA, Pruiksma KE, Yarvis JS, Peterson AL, Mitnz J. Effect of Group vs Individual Cognitive Processing Therapy in Active-Duty Military Seeking Treatment for Posttraumatic Stress Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2017;74(1):28-36.

• Rizvi SL, Vogt DS, Resick PA. Cognitive and Affective Predictors of Treatment Outcome in Cognitive Processing Therapy and Prolonged Exposure for Posttraumatic Stress Disorder. Behaviour Research and Therapy. 2009;47(9), 737-743.

• Safren SA, Gershuny BS, Hendriksen E. Symptoms of Posttraumatic Stress and Death Anxiety in Persons with HIV and Medication Adherence Difficulties. AIDS Patient Care and STDS. 2003;17(12):657-66.

• Whetten K, Reif S, Whetten R, Murphy-McMillan LK. Trauma, Mental Health, Distrust, and Stigma Among HIV-Positive Persons: Implications for Effective Care. Psychosomatic Medicine. 2008;70(5):531-538.

Link to Websites

• PTSD Checklist for DSM-5 with Life Events Checklist for DSM-5 and Criterion A
• Uniformed Services University: Cognitive Processing Therapy
• U.S. Department of Veterans Affairs: PTSD Mobile Applications

Description:

Seeking Safety is a coping skills approach to help people attain safety from trauma and/ or addiction. It is designed to be safe, optimistic, and engaging. The treatment offers 25 topics, each representing a safe coping skill relevant to trauma and substance use disorders. Topics address cognitive, behavioral, interpersonal, and case management domains, and can be covered in any order. Seeking Safety is highly flexible and can be conducted in a group or with individuals, in open or closed groups, with any gender, and with adults or adolescents.

Seeking Safety addresses themes that are very relevant to PLWH, including taking good care of yourself, staying safe, and understanding how trauma and addiction may play a role in living with HIV. A detailed guide on using Seeking Safety with PLWH is available from the Seeking Safety website.

Literature & Resources:

Links to Literature

• Anderson ML, Najavits LM. Does Seeking Safety Reduce PTSD Symptoms in Women Receiving Physical Disability Compensation? Rehabilitation Psychology. 2014; 59(3):349-353.
• Lenz AS, Henesy R, Callender K. Effectiveness of Seeking Safety for Co-Occurring Posttraumatic Stress Disorder and Substance Use. Journal of Counseling & Development. 2016; 94(1):51-61.
• Najavits LM, Hien DA. Helping Vulnerable Populations: A Comprehensive Review of the Treatment Outcome Literature on Substance Use Disorder and PTSD. Journal of Clinical Psychology: In Session. 2013;69 (5):433-479.
• Najavits LM, Hyman SM, Ruglass LM, Hien DA, Read JP. Substance Use Disorder and Trauma. In Gold S, Cook J, Dalenberg C, eds. Handbook of Trauma Psychology: American Psychological Association. 2017; 195-214.

• Wolff N, Huening J, Shi J, Frueh BC, Hoover DR, McHugo G. Implementation and Effectiveness of Integrated Trauma and Addiction Treatment for Incarcerated Men. Journal of Anxiety Disorders. 2015;30;66-80.

Books

• Najavits LM. Seeking Safety. A Treatment Manual for PTSD and Substance Use Disorder. New York: Guilford Press; 2002.
• Najavits LM. Seeking Safety: An Implementation Guide. In Rubin A, Springer DW, (eds). The Clinician’s Guide to Evidence-Based Practice. Hoboken, NJ: John Wiley; 2009.

Link to Websites

• Seeking Safety Main Website
• Benefit-Cost Results: Substance Use Disorders—Seeking Safety

Description:

TIA/CHANGE is a resilience-focused and strength-based approach to HIV service provision that involves understanding, recognizing, and responding to the effects of trauma. While TIA/CHANGE was originally developed for women, HIV care providers can use TIA/ CHANGE for PLWH of all genders.

There is no one-size-fits-all approach to trauma-informed care. As such, an organization must tailor its efforts to develop a model of trauma-informed care that is mission-driven and effective for their local community of PLWH.

Literature & Resources:

Link to Literature

• AIDS United, Christies Place. CHANGE for Women: A Trauma-Informed Model of Care for Women Living with HIV.

• AIDS United, Christies Place. Trauma Informed Care—Improving Services, Saving Lives. Washington, DC; 2017.

• Cattaneo LB, Chapman AR. The Process of Empowerment: A Model for Use In Research and Practice. American Psychologist. 2010; 65:646-659

• Covington SS, Bloom BE. Gender-Responsive Treatment and Services in Correctional Settings. Women & Therapy. 2007;29:3-4,9-33.

• DeBord J, Burke W, Dudzinski DM. Confidentiality. Ethics in Medicine. University of Washington School of Medicine. 2014.

• Ellio DE, Bjelajac P, Fallot RD, Markoff LS, Glover Reed B. Trauma-Informed or Trauma-Denied: Principles and Implementation of Trauma-Informed Services for Women. Journal of Community Psychology. 2005; 33(4), 461-477.

• Ford OG. Transaccess: Connecting Women to Care in the Midst of Complex Lives. The HIV Treatment Journal of Test Positively Aware Network.

• Kuo DZ, Houtrow AJ, Arango P, et al., Family-Centered Care: Current Applications and Future Directions in Pediatric Health Care. Maternal Child Health Journal. 2012; 16(2): 297–305.

• Lamia MC. Your Sense of Agency: Are You in Control of Your Life? Psychology Today. 2010.

• Machtinger EL, Lavin SM, Hilliard S, Jones R, Haberer JE, Capito K, Dawson-Rose C. An Expressive Therapy Group Disclosure Intervention for Women Living with HIV Improves Social Support, Self-Efficacy, and the Safety and Quality of Relationships: A Qualitative Analysis. Journal of the Association of Nurses in AIDS Care. 2015;26(2):187-198.

• Marczak M, Sewell M. Using Focus Groups for Evaluation. CYFERnet-Evaluation. University of Arizona Tucson.

• Trauma and Justice Strategic Initiative. SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach (HHS Publication No. SMA 14-4884). Rockville, MD: Substance Abuse and Mental Health Services Administration;2014.

• UCLA Center for Health Policy Research: Section 4: Key Informant Interviews. Health DATA Program – Data, Advocacy and Technical Assistance

• Wagner, RA. What Is Informed Consent? E-Medicine Health.

• White House Interagency Federal Working Group Report. Addressing the Intersection of HIV/AIDS, Violence against Women and Girls, & Gender-Related Health Disparities, 2013

Link to Websites

• Futures Without Violence: Health E-Bulletin.

• SAMHSA: Trauma-Informed Approach and Trauma-Informed Interventions.