Evidence-Based Therapies for Treating Trauma and Addiction Together

When trauma and substance use collide, “just stop using” rarely feels that simple. For many people, substances started as a way to manage anxiety, sleep, memories, or a nervous system that never fully powers down. That does not make recovery impossible. It does mean the plan often needs to address more than one problem at once.

Why Treating Only Substance Use Can Feel Like It’s Not Working

Some people complete treatment, build momentum, then get blindsided by a trigger. That trigger might be a memory, a conflict, a panic spike, or a feeling that comes out of nowhere. When that happens, cravings can feel less like a choice and more like a reflex.

For many clients, trauma symptoms and substance use are tightly linked. When treatment addresses both, people often have a clearer path forward than when care is split into “one issue now, the other later.” That is not a rule for everyone. It is a common pattern.

What “Evidence-Based” Really Means

In plain terms, evidence-based therapies are approaches that have been studied and show helpful outcomes for many people. No therapy works for every person, and no method can promise a specific result on a specific timeline. Still, research-backed approaches give you a starting point that is stronger than guesswork.

Evidence-supported care often includes:

• Use of structured methods that have been tested in clinical research
  
• Training and supervision for clinicians delivering the model
  
• Clear goals and skills you can practice between sessions
  
• Ongoing measurement of symptoms and progress so the plan can adjust
  

If a provider can explain why they recommend an approach for your symptoms and stage of recovery, that is usually a good sign.

Common Evidence-Based Therapies Used for Trauma and Substance Use

Cognitive Behavioral Therapy

CBT focuses on the relationship between thoughts, feelings, and actions. In dual recovery work, CBT often helps clients:

• Notice the thoughts that show up right before cravings or shutdown
  
• Challenge “all or nothing” thinking that fuels relapse
  
• Practice coping plans for high-risk moments
  
• Build tolerance for discomfort without reaching for substances
  

CBT is often used because it is practical and skill-based. Many people like that it gives them tools they can keep using outside of session.

DBT Skills for Emotional Intensity

DBT was designed for people who feel emotions fast and hard. That can overlap with both trauma symptoms and substance use patterns.

DBT skills are usually taught in four areas:

• Mindfulness
  
• Distress tolerance
  
• Emotion regulation
  
• Interpersonal effectiveness
  

Some clients find distress tolerance skills especially useful in early recovery because they are built for short-term crisis moments. The goal is not to “be calm all the time.” The goal is to get through the spike without making it worse.

EMDR

EMDR is a structured trauma therapy that uses bilateral stimulation (often eye movements) while working through distressing memories. Many people pursue EMDR to reduce how intense trauma memories feel and how easily they get triggered.

A key point: trauma processing is usually best when a person has enough stability and coping skills to handle what comes up. The timeline varies. A clinician will typically look at safety, current substance use, and your support system before moving into deeper memory work.

Motivational Interviewing

MI helps people work through ambivalence. If part of you wants change and part of you is scared to give up the one coping tool that “worked,” you are not alone. MI is collaborative and non-shaming. It focuses on your reasons for change, not someone else’s pressure.

MI is often used early in treatment to improve engagement and help clients build momentum without feeling pushed.

Prolonged Exposure

Prolonged Exposure is a trauma treatment that reduces avoidance by helping clients face memories and situations in a gradual, supported way. Avoidance is understandable, but it can keep PTSD symptoms stuck. PE aims to help the brain learn, over time, that reminders are not the same as danger.

For people in recovery, exposure-based work is often paced carefully. Many clinicians start with stabilization and coping skills before moving into structured exposure.

Acceptance and Commitment Therapy

ACT teaches psychological flexibility. Instead of trying to eliminate every hard thought or feeling, ACT focuses on helping you live in line with your values even when discomfort shows up.

ACT can be a strong fit for people who use substances to escape internal experiences. The target is the pattern of avoidance, not your character.

Group Therapy and Dual Recovery

Individual therapy can be powerful. Group therapy adds something different: real-time practice, connection, and the relief of realizing you are not the only one.

Groups may be:

• Skills-based (CBT or DBT skills practice)
  
• Psychoeducation (learning about trauma, cravings, and relapse patterns)
  
• Process-oriented (working through relationship patterns and emotional experiences)
  

The best fit depends on your symptoms, comfort level, and what you need most right now.

How to Choose the Right Approach for You

There is no single “best” therapy for everyone. A good plan usually considers:

• Current substance use and relapse risk
  
• Trauma symptom severity and stability
  
• Co-occurring anxiety, panic, or depression
  
• Your readiness to talk about the past in detail, or your need to start with skills first
  
• Practical factors like schedule, transportation, and support at home
  

A clinician should be able to explain their recommendation clearly and adjust if the approach is not helping.

What Treatment Can Look Like in Outpatient Care

Many programs follow a general flow:

1. Stabilization and skills-building
   
2. Deeper trauma-focused work when appropriate
   
3. Integration, relapse prevention, and long-term supports
   

Not everyone follows the same path, and progress is rarely perfectly linear. A flexible plan helps.

Getting Help in Akron

Skypoint Recovery in Akron provides outpatient care designed to support substance use treatment and co-occurring mental health needs. If you are using substances to cope with trauma symptoms, you deserve care that takes the full picture seriously.

Skypoint Recovery accepts Medicaid. If you have questions about coverage or next steps, you can call 330-919-6864 or fill out the confidential online form to talk through options and determine what level of care fits your situation.

Recovery is possible. The next step is getting a plan that matches what you are dealing with today.