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Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE)

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Table of Contents

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

About the Author

Sudie E. Back, Ph.D., is a Professor in the Department of Psychiatry and Behavioral Sciences at the Medical University of South Carolina, and a Staff Psychologist at the Ralph H. Johnson Veterans Affairs (VA) Medical Center in Charleston, SC. She is Director of the NIDA-sponsored Drug Abuse Research Training (DART) residency and summer research programs at the Medical University of South Carolina. Edna B. Foa, Ph.D., is a Professor of Clinical Psychology in Psychiatry at the University of Pennsylvania, and Director of the Center for the Treatment and Study of Anxiety. Dr. Foa devoted her academic career to study the psychopathology and treatment of anxiety disorders, primarily obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD). Therese K. Killeen, Ph.D., APRN, is an Associate Professor in the Department of Psychiatry and Behavioral Sciences at the Medical University of South Carolina. Dr. Killeen has over 20 years of experience working with adult and adolescent patients with comorbid PTSD and substance use disorders. Katherine L. Mills, Ph.D., is an Associate Professor at the National Drug and Alcohol Research Centre, University of New South Wales. Dr. Mills is also Director of Treatment Research for the National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Mental Health and Substance Use in Australia. Maree Teesson, Ph.D., is a National Health and Medical Research Council (NHMRC) Senior Research Fellow at the National Drug and Alcohol Research Centre, University of New South Wales, and Director of the NHMRC Centre of Research Excellence in Mental Health and Substance Use in Australia. Bonnie Dansky Cotton, Ph.D., is a senior manager at Microsoft Corporation. She received her PhD in Clinical Psychology from Duke University and completed her internship at the Medical University of South Carolina. Prior to her career at Microsoft, Dr. Cotton was an Assistant Professor in the Department of Psychiatry and Behavioral Sciences at the Medical University of South Carolina. Kathleen M. Carroll, Ph.D., is the Albert E. Kent Professor of Psychiatry at Yale University School of Medicine. She is an internationally renowned researcher on the development of behavioral therapies for substance use disorders. Dr. Carroll is Principal Investigator of the Center for Psychotherapy Development at Yale and Co-Principal Investigator of the New England Consortium of NIDA's Clinical Trials Network. Kathleen T. Brady, MD, Ph.D., is a Distinguished University Professor and Associate Provost for Clinical and Translational Science at the Medical University of South Carolina. Dr. Brady is Director of the Women's Research Center, Director of the MUSC Clinical and Translational Research Center (CTSA), and Director of the Southern Consortium of NIDA's Clinical Trials Network.


This pair of books brings science-based treatment techniques and skills to a population of clients and therapists in urgent need. Based on years of careful and systematic development, these books provide critical training in how to deliver prolonged exposure therapy techniques in those with substance addictions. They are a groundbreaking addition to any trauma and addiction therapist's treatment collection. * Denise Hien, PhD, ABPP, Professor of Clinical Psychology, City College, Graduate Center of the City University of New York * COPE is a long awaited and much needed treatment manual, developed by an outstanding group of clinicians and researchers. COPE will allow exposure therapy, a highly effective treatment for PTSD, to be more readily available to patients who also have a substance use disorder. I recommend this book to anyone who treats patients who have both PTSD and a substance use disorder. * Sonya B. Norman, PhD, Associate Professor, Department of Psychiatry, University of California, San Diego * COPE is a much-needed integrated treatment for substance use and posttraumatic stress disorders. This excellent therapist manual, and its accompanying patient workbook, will provide important guidance for clinicians in delivering COPE, thereby expanding the possibility of providing high-quality integrated care for individuals suffering from both of these illnesses. * Shelly F. Greenfield, MD, MPH, Chief Academic Officer, Chief, Division of Women's Mental Health, and Director of Clinical and Health Services Research and Education, Division of Alcohol and Drug Abuse, McLean Hospital, and Professor of Psychiatry, Harvard Medical School * The Treatments That Work series provides timely and useful additions to the field. The incidence and prevalence of PTSD and concurrent substance use disorder is more than enough reason for this book and it will be invaluable in treatment. Co-morbidity of PTSD and substance use disorders is as challenging as it is common in clinical practice. COPE offers the first integrated approach to treatment of these patients that has a solid foundation in evidence-based techniques and applies insights from basic neuroscience. Our experience with COPE for PTSD patients with alcohol addiction has been truly amazing. * Markus Heilig, MD PhD, Chief, Lab of Clinical and Translational Studies, NIAAA * The COPE therapist guide and patient manual fills a tremendous need . . . Both the manual and workbook are well organised and easy to follow. . . These books raise hope that more individuals with PTSD and SUD will now have access to effective treatment for these disorders. * Sonya B. Norman, National Center for PTSD, University of California, in Drug and Alchohol Review, 35 (Jan. 2016) *

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