Interdisciplinary Issues at the Intersection of Assessing and Treating Substance Use Disorders and Post Traumatic Stress Disorder: Clinical Social Work and Clinical Behavioral Analysis with Veterans

Monica M Matthieu,Robert W Casner,Alyssa Wilson

doi:10.18060/21320

Abstract

Veterans and military personnel may be at higher risk for developing addictions due to increased prevalence rates of co-occurring mental health disorders including posttraumatic stress and substance abuse disorders. However, clinicians may feel unprepared to assess and to treat these co-occurring disorders, especially when it includes a behavioral addiction such as gambling. Clinical social work and clinical behavior analysis are two fields with complementary interdisciplinary approaches that can lead to improved client-centered outcomes. Yet, limited evidence exists to guide interdisciplinary treatment teams in effective treatment of gambling addictions and Post Traumatic Stress Disorder (PTSD). The current article provides an interdisciplinary treatment model to assist clinicians in selecting appropriate evidence-based assessments and treatments. A case example focuses on the use of assessment tools and treatment approaches drawn from recommendations from best practice guidelines for veterans. Finally, resources related trauma and addictions are presented.

Highlights

Veterans and military personnel may be at higher risk for developing addictions due to increased prevalence rates of co-occurring mental health disorders including posttraumatic stress and substance abuse disorders
While the main tool is a functional analysis of the behavior, clinical behavioral analysts examine the biological and social forces that impinge on an individual and apply behavioral, cognitive behavioral, and other behavioral medicine methods to instigate change (Association for Behavior Analysis International, 2017)
The aim of this paper is to provide a framework for clinicians to effectively, and collaboratively, assess and treat Post Traumatic Stress Disorder (PTSD) and substance use disorders, in particular gambling

Summary

Introduction

Veterans and military personnel may be at higher risk for developing addictions due to increased prevalence rates of co-occurring mental health disorders including posttraumatic stress and substance abuse disorders. In 1989, the National Associations of Social Work (NASW) Standards for the Practice of Clinical Social Work defined clinical social work by an emphasis on the process of assessment, diagnosis, intervention, treatment, collaboration, case management, and evaluation of the psychosocial functioning of individuals, families, and small groups (NASW, 1989) As this standard is currently undergoing revision, it can be expected that the collaboration aspect will expand to encompass more modern views on interdisciplinary collaboration with other allied health professions, namely those with similar traditions, theoretical perspectives, and methods. With such common ground as the person-in-environment theoretical perspective, clinical social work and behavior analysis have a special interdisciplinary connectedness that can be helpful in addressing and treating complex behavioral issues Both disciplines subscribe to a process model for clinical practice that includes five steps (Wilson & Matthieu, 2015). Some are gaining more notice and relevance for extremely high-need clients with behavioral issues, such as children with Autism and individuals with complex clinical presentations requiring behavior based interventions, such as veterans with Post Traumatic Stress Disorder (PTSD) and co-occurring substance use or gambling disorders

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