What stage are you in your career, and what is your current affiliation?
I am a Research Assistant Professor at the Medical University of South Carolina (MUSC). In September 2022, I will be joining Rutgers University as a tenure-track Assistant Professor.
How would you describe your research interests?
Broadly, my work seeks to enhance treatments for substance use disorders and co-occurring posttraumatic stress disorder to make them more effective. Much of this work has focused on how to modify treatments to the needs of historically marginalized groups disproportionately impacted by trauma and addiction, such as women, racial/ethnic minorities, and those with complex clinical presentations.
How did you become interested in researching marginalized groups and substance use?
There are personal and professional reasons. Personally, I’m an Indian-American woman who grew up as a minority. I witnessed trauma and saw how people of minoritized backgrounds were more likely to experience trauma. Indeed, my initial interest in psychology was understanding trauma among diverse individuals. Then, through my training, I quickly learned how often trauma/posttraumatic stress disorder (PTSD) co-occurs with substance use and how both conditions are more common among individuals with minority backgrounds. On top of that, most individuals seeking help for their PTSD symptoms and substance use are not given integrated care attending to both of their conditions. All of this led me to question how we could not only increase the uptake of integrated treatments but also enhance such treatments by tailoring them to the specific needs of individuals.
Congratulations on your recent work published in the Journal of Substance Abuse Treatment, titled, “Perspectives on trauma and the design of a technology-based trauma-informed intervention for women receiving medications for addiction treatment in community-based settings.” What do you view as the key takeaways from this work that are important for Division 50 members to know? What are the implications of this work?
Thank you! The most important takeaway is that our treatments need to be disseminated and fit treatment contexts better. This was a qualitative study where we interviewed female patients with opioid use disorder (OUD) and posttraumatic stress disorder (PTSD) symptoms stabilized on medications for an OUD and providers who worked with these women. We asked patients and providers about their mental health experiences and their thoughts on how to design an integrated treatment for such women with technology.
Most women were unaware of the relationship between their traumas and PTSD symptoms with their opioid use and were very intrigued when we discussed this with them. They showed high interest in a gender-specific, trauma-informed, integrated treatment attending to their trauma histories and opioid use but, at the time of the interview, did not receive such care. They also preferred in-person treatment over technology. As for providers, they wanted to provide integrated treatment but they didn’t have the time, training, resources, or frequency of patient visits to complete trauma-informed integrated treatment. Although providers were curious about technology, they noted that if it required additional time to learn, it might be more burdensome. Our findings highlighted the systemic and contextual factors we are up against to help design and implement efficacious treatments. We need to think about educating our patients about trauma and opioid use, providing gender-specific care options, and supporting our providers.
How do you see your research interests evolving in the future?
There are many areas in which I’d like my work to grow! First, I have started to expand my work to traumas beyond criterion A traumas. This includes racial trauma, immigration trauma, collective trauma, and adverse childhood experiences. Second, akin to our findings, I want to get more involved in dissemination and implementation efforts. We have useful treatments but keeping them in the ivory tower or provided to only patients in clinical trials does us no good. Third, based on our findings, I think technology is potentially helpful but needs to be used appropriately. I want to think about how technology can bolster treatment but not replace it. Fourth, we need to design our treatments and train our students and providers to be more flexible and patient-centered. Much of my work is trying to provide additional evidence on how to increase flexibility in the delivery of treatments by incorporating findings about the needs and preferences of specific groups. Recent work by Dr. Kehle-Forbes (2022) demonstrated how flexibility in the delivery of evidence-based treatments increases rates of treatment completion.
What would you like to share with someone in the field of addictive behaviors who is interested in examining marginalized groups in their own work?
Well, first, welcome! I would first say, you’re not alone. I think it can feel like that depending on your immediate context, but there is a group of wonderful people doing this with so many different permutations. I would also share that I have found it helpful to have a good mentor who can guide you on this work, a committed crew of colleagues you can lean on for social support as well as help you grow, to really listen to your participants and patients who are the best informants of what they need, and to try to dampen the competitive nature of research and focus on your intention in your work.
What do you think other researchers in the field of addictive behaviors should consider when conducting research with marginalized populations?
I think it is very important to know your privilege and power as a researcher. This is true in general, but especially when working with minorities with trauma and addiction. Most of us have not gone through the severity of trauma and substance use as those we work with in research and clinical practice have. How you handle yourself while working with participants or patients is key to reducing that power differential. In addition, many patients in trauma and substance use treatment have a marginalized aspect of their identities which has not been attended to in their treatment. The biggest thing you can do to begin this work is to offer your time, to listen, to consult with colleagues who have expertise in this area, and to do your own personal growth work.
Saraiya, T. C., Swarbrick, M., Franklin, L., Kass, S., Campbell, A., & Hien, D. A. (2020). Perspectives on trauma and the design of a technology-based trauma-informed intervention for women receiving medications for addiction treatment in community-based settings. Journal of Substance Abuse Treatment, 112, 92–101. https://doi.org/10.1016/j.jsat.2020.01.011