A Systematic Review of Trauma Informed Care in Substance Use Settings.

Area of Science:

• Public Health
• Psychology
• Organizational Behavior

Background:

• Trauma-informed care (TIC) is increasingly recognized as a vital organizational intervention.
• Substance use disorder (SUD) populations frequently experience trauma and adversity.
• Effective implementation of TIC in SUD settings requires understanding organizational factors.

Purpose of the Study:

• To systematically review the effectiveness of trauma-informed care as an organizational intervention in substance use settings.
• To examine TIC implementation from an organizational perspective.
• To identify facilitators and barriers to TIC implementation in SUD treatment.

Main Methods:

• Systematic review following PRISMA guidelines.
• Searched Academic Search Complete, Embase, Scopus, and Google Scholar (inception to February 2024).
• Included peer-reviewed English articles on TIC in SUD settings with an implementation focus; quality appraisal using Mixed Method Appraisal Tool.

Main Results:

• Fifteen studies (varying quality) reported positive outcomes: reduced substance use, mental health, and trauma symptoms.
• Improved treatment retention and service satisfaction for users and employees were noted.
• Leadership and the 10 trauma-informed implementation domains are crucial for successful implementation.

Conclusions:

• Trauma-informed care is a promising organizational intervention for improving outcomes in substance use settings.
• The 10 trauma-informed care implementation domains can guide effective implementation strategies.
• Further research, particularly quantitative studies, is needed to establish causal inferences.