Acceptability of Lay-Led PTSD and SUD Interventions among Indigenous College Students

The goal of this study was to understand which types of lay-led posttraumatic stress disorder (PTSD) and substance use disorder (SUD) interventions were acceptable to Indigenous college students.

401 Indigenous college students (74.0% women, 18.0% men, 7.6% Two-Spirit, transgender, and non-binary individuals) from North America were recruited as part of a larger study assessing the acceptability of sexual violence interventions for Indigenous college students. Participants reported on their mental health and trauma history, and were randomly assigned to read descriptions of, and evaluate, one lay-led PTSD intervention [written exposure therapy (WET) or narrative exposure therapy (NET)] and one SUD intervention [motivational interviewing (MI) or 12-step programs (ns for complete acceptability data = 180-213)]. Participants also rated the importance of specific intervention elements, including cultural content.

Approximately 40% (41.6%) of participants met criteria for probable PTSD, 37.2% met criteria for probable SUD, and 21.4% met criteria for both probable PTSD and SUD. Most participants (80.0%-86.4%) positively rated each of the four interventions. Participants preferred for interventions to be delivered in college/school settings (70.4%-74.3%) and on Tribal lands/within their community (60.8%-64.6%). Participants also emphasized a strong preference for Indigenous providers (81.9%-89.4%), and cultural content was rated as a moderately important intervention element.

Indigenous college students are highly receptive to different lay-led PTSD and SUD interventions. Findings highlight the need to train Indigenous non-professionals and the importance of both cultural components and intervention components to increase access and acceptability of PTSD and SUD interventions for Indigenous college students.