Dr. James O'Shea:

In terms of the work we do, the interventions that have the best evidence are cognitive therapy for PTSD, which used to be called trauma-focused CBT and EMDR, which is a trauma reprocessing therapy. They are the ones that are most recommended under the international guidelines. If we want to be on the button with evidence for treating trauma effectively and efficiently, we are looking at either CBT or EMDR. They are the interventions that get the very best outcomes. They are also the ones that are easily located within the family of structures for treating addiction. Addiction treatment generally works in quite a structured way and addiction services are generally structured. These interventions are also quite structured so they fit hand in glove into the services that we have.

I treat trauma for a living and I treated addiction for a living for most of my career. It is far easier to treat trauma and to get good outcomes. We still have to treat the addiction alongside it but imagine the levels of distress we can take out of people's lives and their families' lives by treating their trauma symptoms. We have talked about the different levels of trauma intervention, about trauma-focused and trauma-aware care but from an addiction work point of view, one of the most significant interventions is the use of trauma stabilisation programmes, which really teach clients self-regulation, self-management and coping skills to be able to manage their trauma symptoms so that they are able to function in the world despite the fact that they had traumatic life experiences. The other significant intervention, if we want to treat the trauma, as in cure it, is the use of trauma-focused approaches that reprocess the traumatic memories. That is the gold standard we want to be aiming for. There is no reason anybody should have to live with traumatic life experiences if we can offer the appropriate, evidence-based interventions and that is where we need to put our money.