Evidence-based interventions for PTSD are time-intensive and require training to deliver. However, recent studies suggest that the results are well worth the effort. For individuals with co-occurring PTSD and SUD, trauma-focused treatments such as PE and CPT are consistently more likely to lead to improvements by the end of treatment.1 For example, a recent study by our group evaluating a novel prolonged exposure therapy protocol found that a large majority of patients receiving MOUD who completed PE achieved diagnostic remission and no longer met criteria for PTSD. There is also no evidence that PE is associated with any increase in substance use.2 Furthermore, there are very few reasons why someone with PTSD should not receive PE. Accordingly, patients with most co-occurring conditions (e.g., SUDs, dissociative symptoms, moderate-to-severe depression, mild borderline personality disorder) can benefit from these treatments, particularly when the patient is receiving integrated or concurrent treatment for the co-occurring condition.3, 4
In rural communities where distance, costs associated with travel, unreliable transportation, limited childcare, and limited availability of mental health treatment providers may prevent or delay individuals’ ability to seek PTSD treatment, the delivery of these interventions via telehealth may be a particularly helpful option. Fortunately, the delivery of these interventions via telehealth has been studied and found to be effective.5–8 Our group also recently demonstrated the feasibility and initial efficacy of delivering PE via telehealth to individuals receiving MOUD.9, 2