Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE) is a cognitive-behavioral psychotherapy program designed for patients who have posttraumatic stress disorder (PTSD) and a co-occurring alcohol or drug use disorder. COPE represents an integration of two evidence-based treatments:: Prolonged Exposure (PE) therapy for PTSD and Relapse Prevention for substance use disorders. COPE is an integrated treatment, meaning that both the PTSD and substance use disorder are addressed concurrently in therapy by the same clinician, and patients can experience substantial reductions in both PTSD symptoms and substance use severity. Patients use the COPE Patient Workbook while their clinician uses the Therapist Guide to deliver treatment. The program is comprised of 12 individual, 60 to 90 minute therapy sessions. The program includes several components::information about how PTSD symptoms and substance use interact with one another; information about the most common reactions to trauma; techniques to help the patient manage cravings and thoughts about using alcohol or drugs; coping skills to help the patient prevent relapse to substances; a breathing retraining relaxationexercise; and in vivo (real life) and imaginal exposures to target the patients PTSD symptoms.
Chapter 1: Introductory Information for Therapists; Chapter 2: Outline of this Treatment Program; Chapter 3: Session 1: Introduction to COPE; Chapter 4: Session 2: Common Reactions to Truama and Craving Awareness; Chapter 5: Session 3: Developing the In Vivo Hierarchy and Craving Management; Chapter 6: Session 4: Initial Imaginal Exposure; Chapter 7: Session 5: Imaginal Exposure Continued and Planning and Emergencies; Chapter 8: Session 6: Imaginal Exposure Continued and Awareness of High-Risk Thoughts; Chapter 9: Session 7: Imaginal Exposure Continued and Managing High-Risk Thoughts; Chapter 10: Session 8: Imaginal Exposure Continued and Refusal Skills; Chapter 11: Session 9: Imaginal Exposure Continued and Seemingly Irrelevant Decisions (SIDs); Chapter 12: Session 10: Imaginal Exposure Continued and Anger Awareness; Chapter 13: Session 11: Final Imaginal Exposure and Anger Management; Chapter 14: Session 12: Review and Termination; Appendix A: Information Gathering Form; Appendix B: Safety Agreement; Appendix C: Therapist Imaginal Exposure Recording Form; Appendix D: Certificate of Completion; References; About the Authors;
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