Service provider perspectives on treating adolescents with co-occurring PTSD and substance use: challenges and rewards

Emma Louise Barrett (University of New South Wales, Sydney, Australia)
Zachary W. Adams (Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA)
Erin V. Kelly (University of New South Wales, Sydney, Australia)
Natalie Peach (University of New South Wales, Sydney, Australia)
Rachel Hopkins (University of New South Wales, Sydney, Australia)
Bronwyn Milne (Sydney Children’s Hospital Network, Sydney, Australia)
Sudie E. Back (Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Columbia, South Carolina, USA)
Katherine L. Mills (University of New South Wales, Sydney, Australia)

Advances in Dual Diagnosis

ISSN: 1757-0972

Publication date: 7 November 2019



Post-traumatic stress disorder (PTSD) and substance use disorder (SUD) frequently co-occur (PTSD+SUD). The onset of these disorders often occurs during adolescence. There is limited understanding of the perspectives of service providers working with this population. The purpose of this paper is to identify the practices, attitudes, experiences and training needs of Australian service providers treating adolescents with PTSD+SUD.


Service providers in Australia were invited to complete an anonymous online survey regarding their experiences working with adolescents who have PTSD+SUD. Ninety participants completed the 48-item survey that comprised multiple choice and open-ended questions.


Service providers estimated that up to 60 per cent of their adolescent clients with PTSD also have SUD. They identified case management, engaging with caregivers and difficult client emotions as specific challenges associated with working with this population. Despite this, providers rated treating PTSD+SUD as highly gratifying for reasons such as teaching new coping skills, developing expertise and assisting clients to achieve their goals. There were mixed perspectives on how to best treat adolescents with PTSD+SUD, and all participants identified a need for evidence-based resources specific to this population.


This is the first survey of Australian service providers working with adolescents who experience PTSD+SUD. The findings improve our understanding of the challenges and rewards associated with working with this population, and provide valuable information that can enhance clinical training and guide the development of new treatment approaches for this common and debilitating comorbidity.



Barrett, E.L., Adams, Z.W., Kelly, E.V., Peach, N., Hopkins, R., Milne, B., Back, S.E. and Mills, K.L. (2019), "Service provider perspectives on treating adolescents with co-occurring PTSD and substance use: challenges and rewards", Advances in Dual Diagnosis, Vol. 12 No. 4, pp. 173-183.

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