How to Coach Yourself and Others Empowering Coaching And Crisis Interventions | Page 182

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Historically, women have not been routinely screened for a history of trauma or assessed to determine a
diagnosis of PTSD across treatment settings (Najavits 2004). Among women in substance abuse treatment, it
has been estimated that 55–99 percent have experienced trauma—commonly childhood physical or sexual
abuse, domestic violence, or rape (Najavits et al. 1997; Triffleman 2003). Studies have reported that current
PTSD rates among women who abuse substances range between 14 to 60 percent (Brady 2001; Najavits et al.
1998; Triffleman 2003). In comparison to men, women who use substances are still more than twice as likely to
have PTSD (Najavits et al. 1997). Brief screening is paramount in not only establishing past or present traumatic
events but in identifying PTSD symptoms. Upon identification of traumatic stress symptoms, counselors need to
refer the women for a mental health evaluation in order to further assess the presenting symptoms, to determine
the appropriateness of a PTSD diagnosis, and to assist in establishing an appropriate treatment plan and
approach. Brief screenings are used to identify clients who are more likely to have were not normal and were
abusive. Some women do not remember the abuse. Therefore, a negative finding on abuse at an intake screening
should not be taken as a final answer. The Substance Abuse and Mental Health Services Administration
(SAMHSA)-funded Women, Co-Occurring Disorders and Violence Study includes questions about sexual
abuse in its baseline interview protocol, presented in Figure 4-6. In addition, SAMHSA’s CSAT has developed
a brochure for women that defines childhood abuse and informs the reader of how to begin to address childhood
abuse issues while in treatment (CSAT 2003a). TIP 36 Substance Abuse Treatment for Persons With Child
Abuse and Neglect Issues (CSAT 2000b) includes detailed information on this topic.

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