Perspectives on Coping with Post-traumatic Stress and Substance Use Disorders: A Photovoice Study

This photovoice study explores the experiences of adaptive coping and safety amongst adults with co-occurring post-traumatic stress disorder (PTSD) and substance use disorder (SUD). Participants (n = 6) were purposively sampled from Seeking Safety groups at a community mental health centre in the United States of America. Participants identified primarily as women (83 per cent), white (50 per cent) and had a mean age of 42 years (standard deviation = 11). Data were gathered through individual photo-elicitation interviews. Through reflexive thematic analysis, the authors generated five themes related to coping safely with distress: (1) similar to other views on mental health recovery, the process of learning to cope with distress was framed as a journey; (2) participants cited several behavioural and meaning-making strategies for coping with distress; (3) feelings of agency were promoted through mastery of wellness skills; (4) healthy personal and professional relationships contributed to positive growth and use of adaptive coping strategies; and (5) participants’ social and physical environments greatly impacted perceptions of safety. Findings provide new evidence on the range of adaptive coping strategies persons with SUD and PTSD employ to realise feelings of safety and the assets relationships and communities can provide to support post-traumatic growth and recovery.