Integrated exposure-based therapy for co-occurring post-traumatic stress and substance use among young people: a randomized controlled trial.

TL;DR

COPE-A, an integrated exposure-based treatment for PTSD and substance use disorder in adolescents/young adults (12–25 years), produced significantly greater reductions in PTSD severity at 4 months compared to supportive counselling control, with sustained improvements at 12 months and higher client satisfaction.

Key findings

• COPE-A demonstrated significantly greater PTSD symptom reduction at 4 months (mean difference −9.82) and higher odds of PTSD remission (OR=0.06) versus person-centred therapy control
• Both groups showed significant substance use and SUD severity improvements at 12 months, with no between-group differences
• Client satisfaction was significantly higher in COPE-A compared to control; no treatment-related adverse events were reported
• Study included 55 young people (69% female, ages 12–25) recruited in Sydney between 2018–2022

Why this matters at the bedside

Provides evidence for safety and efficacy of developmentally-adapted integrated exposure-based therapy for comorbid PTSD and SUD in adolescents and young adults, a population with high disorder onset but limited evidence base for integrated treatments.