Contemporary Trauma Theory and Trauma-Informed Care in Substance Use Disorders: A Conceptual Model for Integrating Coping and Resilience

  • Revital Goodman
Keywords: Childhood-trauma, ACE, TIC, substance use disorders, coping, resilience


National data of children’s exposure to traumatic experiences are alarming. Research asserts the interconnectedness between experiencing childhood trauma (CT) or adverse childhood experiences (ACE) and developing substance use disorders (SUDs) in later adulthood. Trauma definition and contemporary trauma theory (CTT) provide the foundation for trauma informed care (TIC) in social work practice with co-occurring trauma and SUDs. TIC re-conceptualizes SUDs as a mechanism to cope with the effects of trauma. Coping and resilience are relevant factors to the ramifications of CT on SUDs, and are the manifestation of key TIC principles. Integrating TIC practices aimed at enhancing coping and resilience into treatment for co-occurring trauma and SUDs is needed in order to negate the devastating impact of trauma and propel recovery. Conclusions and implications to social work practice are discussed. 


Author Biography

Revital Goodman
Dr. Goodman is a LCSW, a CCTP, and a Certified EMDR Clinicain.


Armstrong, A. R., Galligan, R. F., & Critchley, C. R. (2011). Emotional intelligence and psychological resilience to negative life events. Personality and Individual Differences, 51, 331-336. doi:

Back, S. E., Killeen, T. K., Teer, A. P., Hartwell, E. E., Pederline, A., Beylotte, F., & Cox, E. (2014). Substance use disorders and PTSD: An exploratory study of treatment preferences among military veterans. Addictive Behaviors, 39, 369-373. doi:

Badenoch, B. (2008). Being a brain-wise therapist: A practical guide to interpersonal neurobiology. New York: W. W. Norton.

Banducci, A. N., Hoffman, E., Lejuez, C. W., & Koenen, K. C. (2014a). The relationship between child abuse and negative outcomes among substance users: Psychopathology, health, and comorbidities. Addictive Behaviors, 39, 1522–1527.

Banducci, A. N., Hoffman, E. M., Lejuez, C. W., Koenen, K. C. (2014b). The impact of childhood abuse on inpatient substance users: Specific links with risky sex, aggression, and emotion dysregulation. Child Abuse & Neglect, 38, 928-938. doi:

Beauvais, F., & Oetting, E. R. (1999). Drug use, resilience, and the myth of the golden child. In M. D. Glantz & J. L. Johnson (Eds.), Resilience and development: Positive life adaptations, (pp. 101-107). New York: Kluwer Academic/Plenum Publishers.

Becker-Blease, K. A., & Freyd, J. J. (2005). Beyond PTSD: An evolving relationship between trauma theory and family violence research. Journal of Interpersonal Violence, 20(4), 403-411. doi:

Bloom, L. B., & Farragher, F. (2011). Destroying sanctuary: The crisis in human service delivery system. New York: Oxford University Press.

Bombardier, C., Blake, K., Ehde, D., Gibbons, L., Moore, D., & Kraft, G. (2004). Alcohol and drug abuse among persons with multiple sclerosis. Multiple Sclerosis, 10(1), 35-40. doi:

Brown, S. M., Baker, C. N., & Wilcox, P. (2012). Risking connection trauma training: A pathway toward trauma-informed care in child congregate care settings. Psychological Trauma: Theory, Research, Practice, and Policy, 4(5), 507-515. doi:

Brucker, D. (2007). Estimating the prevalence of substance use, abuse, and dependence among Social Security Disability benefit recipients. Journal of Disability Policy Studies, 18(3), 148-159. doi:

Chou, C. C., Robb, J. L., Clay, M. C., & Chronister, J. N. (2013). Social support as a mediator between internalized stigma and coping behaviors of individuals with substance abuse issues. Rehabilitation Research, Policy, and Education, 27(2), 104-107. doi:

Courtois, C. A. (2008). Complex trauma, complex reactions: Assessment and treatment. Psychological Trauma: Theory, Research, Practice, and Policy, S(1), 86-100. doi:

Courtois, C. A., & Ford, J. D. (2016). Treatment of complex trauma: A sequenced, relationship-based approach. NY: Guilford Press.

Covington, S. S. (2008). Women and addiction: A trauma informed approach. Journal of Psychoactive Drugs, 5, 377-385. doi:

Cowell, R. A., Cicchetti, D., Rogosch, F. A., & Toth, S. L. (2015). Childhood maltreatment and its effect on neurocognitive functioning: Timing and chronicity matter. Development and Psychopathology, 27, 521-533. doi:

Dickey, B., Azeni, H., Weiss, R., & Sederer, L. (2000). Schizophrenia, substance-use disorders, and medical co-morbidity. Journal of Mental Health Policy and Economics, 3, 27-33. doi:<27::AID-MHP67>3.0.CO;2-P

Downey, L. A., Johnston, P. J., Hansen, K., Birney, J., & Stough, C. (2010). Investigating the mediating effects of emotional intelligence and coping on problem behaviors in adolescents. Australian Journal of Psychology, 62(1), 20-29. doi:

Driessen, M., Schulte, S., Luedecke, C., Schaefer, I., Sutmann, F., Ohlmeier, M., …the TRAUMAB-Study Group. (2008). Trauma and PTSD in patients with alcohol, drug, or dual dependence: A multi-center study. Alcoholism Clinical and Experimental Research, 32(3), 481-488. doi:

Dube, S. R., Felitti, V. J., Dong, M., Chapman, D. P., Giles, W. H., & Anda, R. F. (2003). Childhood abuse, neglect, and household dysfunction and the risk of illicit drug use: The Adverse Childhood Experiences Study. Pediatrics, 111(3), 564-572. doi:

Elwyn, L., & Smith, C. (2013). Child maltreatment and adult substance abuse: The role of memory. Journal of Social Work Practice in the Addictions, 13, 269-294. doi:

Erozkan, A. (2013). Exploring the relationship between perceived emotional intelligence and coping skills of undergraduate students. International Journal of Human Sciences, 10(1), 1537-1549.

Farrugia, P. L., Mills, K. L., Barrett, E., Back, S. E., Teesson, M., Baker, A.,…Brady, K. T. (2011). Childhood trauma among individuals with co-morbid substance use and post- traumatic stress disorder. Mental Health and Substance Use, 4(4), 314-326. doi:

Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V.,… Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (Ace) Study. American Journal of Preventive Medicine, 14(4), 245-258. doi:

Finkelhor, D., Turner, H. A., Shattuck, A., & Hamby, S. L. (2013). Violence, crime, and abuse exposure in a national sample of children and youth. Jama Pediatrics, 42, 614-621. doi:

Finkelhor, D., Turner, H., Shattuck, A., Hamby, S., & Kracke, K. (2015). Children’s exposure to violence, crime, and abuse: An update. U.S. Department of Justice: Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention. Retrieved from

Franken, I. H. A., Hendriks, V. M., Haffmans, J., & van der Meer, C. W. (2003). Coping style of substance-abuse patients: Effects of anxiety and mood disorders on coping change. Journal of Clinical Psychology, 59(10), 1125–1132. doi:

Handley, E. D., Rogosch, F. A., Guild, D. J., & Cicchetti, D. (2015). Neighborhood disadvantage and adolescent substance use disorder: The moderating role of maltreatment. Child Maltreatment, 20(3), 193-202. doi:

Harris, W. W., Lieberman, A. F., & Marans, S. (2007). In the best interests of society. Journal of Child Psychology and Psychiatry, 48(3), 392-411. doi:

Heffernan, K., Cloitre, M., Tardiff, K., Marzuk, P. M., Portera, L., & Leon, A. C. (2000). Childhood trauma as a correlate of lifetime opiate use in psychiatric patients. Addictive Behaviors, 25, 797-803. doi:

Henderson, N., & Milstein, M. (1996). Resiliency in schools: Making it happen for students and educators. Thousand Oaks, CA: Corwin Press.

Herman, J. L. (1992). Trauma and recovery: The aftermath of violence - from domestic abuse to political terror. New York: Basic Books.

Jung, H., Herrenkohl, T. I., Klika, J. B., Olivia-Lee, J. O., & Brown, E. C. (2014). Does child maltreatment predict adult crime? Reexamining the question in a prospective study of gender differences, education, and marital status. Journal of Interpersonal Violence, 30(13), 1-20. doi:

Khantzian, E. J., & Albanse, M. J. (2008). Understanding addiction as self-medication: Finding hope behind the pain. Lanham, MD: Rowman & Littlefield.

Keyser-Marcus, L., Alvanzo, A., Rieckmann, T., Thacker, L., Sepulveda, A., Forcehimes,…Svikis, D. S. (2015). Trauma, gender, and mental health symptoms in individuals with substance use disorders. Journal of Interpersonal Violence, 30(1), 3-24. doi:

Kuper, L. E., Gallop, R., & Greenfield, S. F. (2010). Changes in coping moderate substance abuse outcomes differentially across behavioral treatment modality. The American Journal on Addictions, 19, 543-549. doi:

Laplanche, J., & Pontalis, J. B. (1973). The language of psycho-analysis. London: Hogarth Press.

Levendosky, A. A., & Buttenheim, M. (2010). A multi-method treatment for child survivors of sexual abuse: An intervention informed by relational and trauma theories. Journal of Child Sexual Abuse, 9(2), 1-19. doi:

Levenson, J. S. (2014). Incorporating trauma-informed care into sex offender treatment. Journal of Sexual Aggression, 20(1), 9-22. doi:

Levenson, J. (2015). Adverse childhood experiences and subsequent substance abuse in a sample of sexual offenders: Implications for treatment and prevention. Victims & Offenders, 11(2), 199-224. doi:

Levenson, J. (2016). Adverse childhood experiences and subsequent substance abuse in a sample of sexual offenders: Implications for treatment and prevention. Victims & Offenders, 11(2), 199-224. doi:

Levenson, J., & Grady M. (2016). Substance abuse, violence, and childhood adversity: Implications for trauma-informed social work practice. Journal of Social Practice in the Addictions, 16(1), 24-45. doi:

Lewis, J. D. (2012). Towards a unified theory of trauma and its consequences. International Journal of Applied Psychoanalytic Studies, 9(4), 298-317. doi:

Liu, Y., Wang, Z., & Lü, W. (2013). Resilience and affect balance as mediators between trait emotional intelligence and life satisfaction. Personality and Individual Differences, 54, 850-855. doi:

Lizeretti, N. P., Extremera, N., & Rodriguez, A. (2012). Perceived emotional intelligence and clinical symptoms in mental disorders. Psychiatric Quest, 83, 407-418. doi:

Lyvers, S. L. M., & Edward, M. S. (2008). Childhood sexual abuse and substance abuse in relation to depression and coping. Journal of Substance Use, 13(5), 349-360. doi:

Mészáros, J. (2010). Building blocks toward contemporary trauma theory: Ferenczi’s paradigm shift. American Journal of Psychoanalysis, 70, 328-340. doi:

Mikolajczak, M., Nelis, D., Hansenne, M., & Quoidbach, J. (2008). If you can regulate sadness, you can probably regulate shame: associations between trait emotional intelligence, emotion regulation and coping efficiency across discrete emotions. Personality and Individual Differences, 44, 1356-1368. doi:

Montgomery, J. M., Schwean, V. L., Burt, J-A. G., Dyke, D. I., Thorne, K. J., Hindes, Y. L.,…Kohut, C. S. (2008). Emotional intelligence and resiliency in young adults with Asperger's disorder challenges and opportunities. Canadian Journal of School Psychology, 23(1), 70-93. doi:

National Center for Mental Health Promotion and Youth Violence Prevention. (2012). Childhood trauma and its effects on healthy development. Retrieved from

Nijenhuis, E. R. S., & van der Hart, O. (2011). Dissociation in trauma: A new definition and comparison with previous formulations. Journal of Trauma & Dissociation, 12(4), 416-445. DOI: 10.1080/15299732.2011.570592

O’Connor, M., & Elklit, A. (2008). Attachment styles, traumatic events, and PTSD: A cross- sectional investigation of adult attachment and trauma. Journal of Attachment and Human Development, 10(1), 59-71. doi:

Oshri, A., & Rogosch, F. A. (2013). Child maltreatment and mediating influences of childhood personality types on the development of adolescent psychopathology. Journal of Clinical Child & Adolescent Psychology, 42(3), 287-301. doi:

Perera, H. N., & DiGiacomo, M. (2015). The role of trait emotional intelligence in academic performance during the university transition: An integrative model of mediation via social support, coping, and adjustment. Personality and Individual Differences, 83, 208-213. doi:

Ringel, S., & Brandell, J. R. (Eds.). (2012). Trauma: Contemporary directions, theory, practice, and research. Thousand Oaks, CA: Sage. doi:

Roberts, A. C., Galassi, J. P., McDonald, K., & Sachs, S. (2002). Re-conceptualizing substance abuse treatment in therapeutic communities: Resiliency theory and the role of social work practitioners. Journal of Social Work Practice in the Addictions, 2(2), 53-68. doi:

Ross, C. A. (2000). The trauma model: A solution to the problem of comorbidity in psychiatry. Richardson, TX: Manitou Communications.

Saklofske, D. H., Austin, E. J., Galloway, J., & Davidson, K. (2007). Individual difference correlates of health-related behaviors: preliminary evidence for links between emotional intelligence and coping. Personality and Individual Differences, 42, 491-502. doi:

Salovey, P., & Sluyter, D. J. (Eds.). (1997). Emotional development and emotional intelligence. New York: BasicBooks.

Schneider, T. R., Lyons, J. B., & Khazon, S. (2013). Emotional intelligence and resilience. Personality and Individual Differences, 55, 909-914. doi:

Schutte, N. S., Malouff, J. M., & Hine, D. W. (2011). The association of ability and trait emotional intelligence with alcohol problems. Addiction Research and Theory, 19(3), 260-265. doi:

Shapiro, R. (2010). The trauma treatment handbook: Protocols across the spectrum. New York: W. W. Norton.

Shapiro, F. (2012). Getting past your past: Take control of your life with self-help techniques from EMDR therapy. NY: Rodale Books.

Siegal, D. J. (1999). The developing mind: How relationships and the brain interact to shape who we are. New York: Guilford.

Siegal, D. J. (2010). Mindsight: The new science of personal transformation. NY: Bantam Books.

Smyth, N. J., & Wiechelt, S. A. (2005). Drug use, self-efficacy and coping skills among people with concurrent substance abuse and personality disorders: Implications for relapse prevention Journal of Social Work Practice in the Addictions, 5(4), 63-80. doi:

Substance Abuse and Mental Health Services Administration [SAMHSA]. (2012).Trauma definition. Part one: Defining trauma. Retrieved from

SAMHSA. (2015). Trauma-Informed approach and trauma-specific interventions. Retrieved from:

Suleiman, S. R. (2008). Judith Herman and contemporary trauma theory. Women's Studies Quarterly, 36, 1(2), 276-281. doi:

Tarren-Sweeney, M. (2013). An investigation of complex attachment- and trauma-related symptomatology among children in foster and kinship care. Child Psychiatry and Human Development, 44(6), 727- 741. doi:

Toker, T., Ti̇ryaki̇, H., Ozçürümez, G., & Iskender, B. (2011). The relationship between traumatic childhood experiences and proclivities towards substance abuse, self-esteem and coping strategies. Turkish Journal of Psychiatry, 22(2), 83-92.

Torchalla, I., Nosen, L., Rostam, H., & Allen, P. (2012). Integrated treatment programs for individuals with concurrent substance use disorders and trauma experiences: A systematic review and meta-analysis. Journal of Substance Abuse Treatment, 42, 65-77. doi:

Toth, S., Gravener-Davis, J. A., Guild, D. J., & Cicchetti, D. (2013). Relational interventions for child maltreatment: Past, present, and future perspectives. Development and Psychopathology, 25, 1601-1617. doi:

Turner, H. A., Finkelhor, D., & Ormrod, R. (2010). Poly-victimization in a national sample of children and youth. American Journal of Preventive Medicine, 38(3), 323- 330. doi:

U.S. Department of Health and Human Services (HHS), Office of the Surgeon General, (2016). Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. Washington, DC: HHS.

Valtonen, K., Sogren, M., & Cameron-Padmore, J. (2006). Coping styles in persons recovering from substance abuse. British Journal of Social Work, 36, 57-73. doi:

van Dam, D. V., Ehring, T., Vedel, E., & Emmelkamp, P. M. G. (2013). Trauma-focused treatment for posttraumatic stress disorder combined with CBT for severe substance use disorder: A randomized controlled trial. BMC Psychiatry, 13, 172-185.

Van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. New York: Penguin Group, LLC.

Van der Kolk, B., McFarlane, A. C., & Weisaeth, L. (2006). Traumatic stress: The effects of overwhelming experiences on mind, body, and society. NY: Guilford.

Weiland, B. J., Nigg, J. T., Welsh, R. C., Yau, W-Y. W., Zubieta, J-K., Zucker, R. A., & Heitzeg, M. M. (2012). Resiliency in adolescents at high risk for substance abuse: Flexible adaptation via subthalamic nucleus and linkage to drinking and drug use in early adulthood. Alcoholism: Clinical and Experimental Research, 36(8), 1355-1364. doi:

Williams, W. I. (2006). Complex trauma: Approaches to theory and treatment. Journal of Loss and Trauma, 11, 321-335. doi:

Wu, N. S., Schairer, L. C., Dellor, E., & Grella, C. (2010). Childhood trauma and health outcomes in adults with comorbid substance abuse and mental health disorders. Addictive Behaviors, 35, 68-71. doi:

Zeidner, M., Kloda, I., & Matthews, G. (2013). Does dyadic coping mediate the relationship between emotional intelligence (EI) and marital quality? Journal of Family Psychology, 27(5), 795-805. doi:

Zeidner, M., Matthews, G., & Roberts, R. D. (2012). The emotional intelligence, health, and well-being nexus: What have we learned and what have we missed? Applied Psychology: Health and Well-Being, 4(1), 1-30. doi: