Third-Wave Behavioral Therapies for the Co-Occurrence of PTSD and Substance Use Disorders

This chapter aims to spur further research on third-wave behavioral therapies for the comorbidity. It reviews of relevant theoretical and empirical research on the functional relationship between posttraumatic stress disorder (PTSD)/substance use disorder (SUD) and the potential utility of third-wave behavioral therapies in addressing PTSD/SUD. The chapter presents an overview of different third-wave behavioral therapies and a brief description of each treatment, followed by a discussion of extant research on the utility of each treatment in addressing PTSD/SUD. Research on emotion regulation deficits among individuals with PTSD/SUD suggests that individuals with co-occurring PTSD/SUD may be at high risk to engage in maladaptive behaviors to obtain short-term relief from internal experiences perceived as aversive and intolerable, especially emotions. Clinical trials that explicitly examine the efficacy of modified Dialectical Behavior Therapy (DBT) in addressing co-occurring PTSD/SUD are needed. The treatment target hierarchy of DBT would assist therapists in prioritizing order in which to address problem behaviors and symptoms.