Original Article

Characteristics of a Southern Intensive Trauma- and Psychiatric-Focused Recovery Program

Authors: Marisa Giggie, MD, MPAff, Madison Boudreaux, BS, Emma Harper, BS


Objectives: Treatment of substance use disorders (SUDs) is complex, involving biological, psychological, and social factors to be considered when designing effective programs. Trauma-informed psychiatric care integrated with a developmentally appropriate intensive 12-step approach is being used at A Reprieve for Women (Reprieve), a long-term intensive residential recovery program for female emerging adults with SUDs located in Tuscaloosa, Alabama. The Reprieve treatment philosophy focuses on long-term intensive care, treatment of coexisting trauma and psychiatric disorders, and development of life skills. The purpose of this article is to outline Reprieve’s programmatic features and report Reprieve’s 1- and 2-year sobriety rates for women who completed the 6-month residential program and compare it with national sobriety rates for other residential SUD treatment programs.

Methods: Reprieve provided 1- and 2-year sobriety rates and duration of treatment from 110 deidentified participants who completed Reprieve’s 6-month residential program between September 2016 and November 2020. The researchers defined sobriety as complete abstinence from any addictive substances. Reprieve staff contacted program graduates to determine sobriety status following completion of the program. This research, approved by the University of Alabama’s institutional review board, involved usable data points from 68 of the 110 participants.

Results: We determined that Reprieve has a 75% 1-year sobriety rate and a 63% 2-year sobriety rate. The national average sobriety rate for people completing SUD treatment in residential programs is 40%.

Conclusions: Reprieve’s higher-than-national sobriety rates make it a valuable program to study. Its emphasis on the treatment of coexisting psychiatric problems and past traumas, development of life skills, and the unique needs of female emerging adults may contribute to the program’s success. It is hoped that this program description and preliminary analysis of outcomes will provide valuable information for future SUD treatment program development. More rigorous study is needed to delineate the effects of specific programmatic features on sobriety.

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1. Elswick A, Fallin-Bennett A, Ashford K, et al. Emerging adults and recovery capital: barriers and facilitators to recovery. J Addict Nurs 2018;29:78-83.
2. Substance Abuse and Mental Health Services Administration. Key substance use and mental health indicators in the United States: results from the 2017 National Survey on Drug Use and Health. https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHFFR2017/NSDUHFFR2017.pdf. Published September 2018. Accessed June 16, 2023.
3. Manuel JI, Yuan Y, Herman DB, et al. Barriers and facilitators to successful transition from long-term residential substance abuse treatment. J Subst Abuse Treat 2017;74:16-22.
4. McHugh RK, Votaw VR, Sugarman DE, et al. Sex and gender differences in substance use disorders. Clin Psychol Rev 2018;66:12-23.
5. Greenfield SF, Grella CE. Alcohol & drug abuse: what is “women-focused” treatment for substance use disorders? Psychiatr Serv 2009;60:880-882.
6. Klaman SL, Isaacs K, Leopold A, et al. Treating women who are pregnant and parenting for opioid use disorder and the concurrent care of their infants and children: literature review to support national guidance. J Addict Med 2017;11:178-190.
7. Liebschutz J, Savetsky JB, Saitz R, et al. The relationship between sexual and physical abuse and substance abuse consequences. J Subst Abuse Treat 2002;22:121-128.
8. Miller BA, Downs WR, Gondoli DM, et al. The role of childhood sexual abuse in the development of alcoholism in women. Violence Vict 1987;2:157-172.
9. Huang S, Trapido E, Fleming L, et al. The long-term effects of childhood maltreatment experiences on subsequent illicit drug use and drug-related problems in young adulthood. Addict Behav 2011;36:95-102.
10. Lown EA, Nayak MB, Korcha RA, et al. Child physical and sexual abuse: a comprehensive look at alcohol consumption patterns, consequences, and dependence from the National Alcohol Survey. Alcohol Clin Exp Res 2011;35:317-325.
11. Brunette MF, Mueser KT, Drake RE. A review of research on residential programs for people with severe mental illness and co-occurring substance use disorders. Drug Alcohol Rev 2004;23:471-481.
12. Pedrelli P, Nyer M, Yeung A, et al. College students: mental health problems and treatment considerations. Acad Psychiatry 2015;39:503-511.
13. Ridgely MS, Goldman HH, Talbott JA. Treatment of chronic mentally ill young adults with substance abuse problems: emerging national trends. Adolesc Psychiatry 1989;16:288-313.
14. Mago VK, Morden HK, Fritz C, et al. Analyzing the impact of social factors on homelessness: a fuzzy cognitive map approach. BMC Med Inform Decis Mak 2013;13:94.
15. Greenfield L, Burgdorf K, Chen X, et al. Effectiveness of long-term residential substance abuse treatment for women: findings from three national studies. Am J Drug Alcohol Abuse 2004;30:537-550.
16. McLellan AT, Grissom GR, Brill P, et al. Private substance abuse treatments: are some programs more effective than others? J Subst Abuse Treat 1993;10: 243-254.
17. Turnbridge. Differences: addiction treatment outcomes study. https://www.turnbridge.com/differences/outcome-study. Accessed March 21, 2022.
18. Humphreys K, Kaskutas LA,Weisner C. The Alcoholics Anonymous Affiliation Scale: development, reliability, and norms for diverse treated and untreated populations. Alcohol Clin Exp Res 1998;22:974–978.
19. Donovan DM, Ingalsbe MH, Benbow J, et al. 12-step interventions and mutual support programs for substance use disorders: an overview. Soc Work Public Health 2013;28:313-332.
20. Moshki M, Hassanzade T, Taymoori P. Effect of life skills training on drug abuse preventive behaviors among university students. Int J Prev Med 2014; 5:577-583.
21. Fallot RD, Harris M. The Trauma Recovery and Empowerment Model (TREM): conceptual and practical issues in a group intervention for women. Community Ment Health J 2002;38:475-485.
22. Polcin DL. Communal living settings for adults recovering from substance abuse. J Groups Addict Recover 2009;4:7-22.
23. Bebout RR, Drake RE, Xie H, et al. Housing status among formerly homeless dually diagnosed adults. Psychiatr Serv 1997;48:936-941.
24. Cripe CT, Mikulecky P, Sucher M, et al. Improved sobriety rates after braincomputer interface-based cognitive remediation training.Cureus 2022;14:e21429.
25. Addiction Center. Cost of drug and alcohol rehab. https://www.addictioncenter.com/rehab-questions/cost-of-drug-and-alcohol-treatment/. Accessed August 7, 2022.
26. The PEW Charitable Trusts. The high price of the opioid crisis. https://www.pewtrusts.org/-/media/assets/2021/09/highpriceofopioidcrisis_infographic_2021_final.pdf. Published 2021. Accessed June 16, 2023.