What is Trauma-Informed Care in Addiction Treatment?

By Ryan Hatfield | January 2, 2026

For many individuals struggling with substance use disorder, the roots of addiction extend far beyond the substance itself. Trauma—whether from childhood experiences, significant life events, or ongoing stressors—often plays a central role in the development and progression of addiction. At High Watch Recovery Center, we recognize this profound connection and have integrated trauma-informed care into our comprehensive addiction treatment programs.

Understanding Trauma and Its Connection to Addiction

Trauma can take many forms: physical or emotional abuse, neglect, loss of a loved one, accidents, natural disasters, or witnessing violence. According to the CDC-Kaiser Permanente Adverse Childhood Experiences (ACE) Study, individuals with higher ACE scores have significantly increased risk for substance use disorders. These traumatic experiences can fuel the development of SUDs as individuals may turn to substance use as a coping mechanism to relieve distress, escape reality, and self-medicate.

The very nature of addiction itself is intertwined with trauma. As the American Society of Addiction Medicine (ASAM) defines it, substance use disorder is “a primary chronic disease of brain reward, motivation, memory, and related circuitry.” Research from the National Institute on Drug Abuse (NIDA) confirms that trauma impacts these same brain systems, creating a complex interplay between past experiences and present struggles.

The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that up to 75% of individuals in substance abuse treatment have experienced significant trauma, highlighting the critical need for trauma-informed approaches in addiction treatment.

What Makes Care “Trauma-Informed”?

Trauma-informed care represents a fundamental shift in how we approach addiction treatment. Rather than asking “What’s wrong with you?” trauma-informed care asks “What happened to you?” This perspective recognizes that behaviors associated with addiction often represent survival strategies developed in response to overwhelming experiences.

SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach outlines six key principles of trauma-informed care: safety, trustworthiness and transparency, peer support, collaboration and mutuality, empowerment and choice, and cultural sensitivity.

At High Watch, trauma-informed care means:

Creating Safety: From the moment guests arrive at our 300-acre campus nestled in the Litchfield Hills of Connecticut, we prioritize physical and emotional safety. Our peaceful, judgment-free environment allows individuals to begin healing without fear of re-traumatization.

Building Trust: Our experienced clinical staff understands that trust must be earned, especially for those who have experienced betrayal or harm. We maintain transparency in our treatment processes and honor each guest’s autonomy in their recovery journey.

Recognizing Triggers: Through our comprehensive assessment process, we work with guests to identify potential triggers—situations, emotions, or experiences that may activate trauma responses—and develop healthy coping strategies.

Empowering Choice: Trauma often involves a loss of control. Our treatment approach emphasizes collaboration and shared decision-making, helping guests reclaim their sense of agency.

Trauma-Informed Therapies at High Watch

Our clinical team offers several specialized therapeutic approaches specifically designed to address trauma:

Individual Therapy

Each guest in our residential treatment program works one-on-one with an assigned therapist who utilizes trauma-informed modalities tailored to individual needs. These evidence-based approaches, recognized by the National Center for PTSD, include:

Internal Family Systems (IFS): This approach, supported by research from the Center for Self Leadership, helps individuals understand different “parts” of themselves that developed in response to trauma
Cognitive Behavioral Therapy (CBT): Helps reshape thought patterns that emerged from traumatic experiences, with strong evidence from the American Psychological Association
Desensitization techniques: Gradually reduces the emotional impact of traumatic memories

Specialized Group Therapy

The Impact of Trauma Group: This dedicated group helps guests gain a deeper understanding of trauma’s role in their addiction. Research from SAMHSA’s Treatment Improvement Protocol on Trauma-Informed Care confirms that this awareness “equips individuals with insights into the underlying causes and triggers that may influence their substance use. This awareness can foster greater self-reflection, empathy, and compassion for themselves and others.”

Family Constellation Therapy: This innovative approach addresses underlying family dynamics that may have contributed to or worsened addiction. By exploring family relationships and revealing hidden patterns, this therapy helps guests:

Uncover family patterns that influence addiction
Release repressed emotions and traumas
Resolve family conflicts
Strengthen family relationships for long-term support

Stress Management: Our stress management groups help individuals develop healthier coping mechanisms for handling triggers and cravings related to past substance use. By recognizing and controlling these stress triggers, those in recovery can make informed decisions without turning to substance abuse.

Creative and Somatic Therapies

Art Therapy: Our creative art therapy program provides a “safe and nonjudgmental environment for individuals to express their thoughts, feelings, and experiences through artistic creations.” Research published by the American Art Therapy Association demonstrates that for trauma survivors who may struggle to verbalize their experiences, art becomes a cathartic outlet that enables them to “release pent-up emotions and develop a deeper understanding of their psychological landscape.”

Equine-Assisted Learning: Through our partnership with The Equus Effect, guests engage with horses in a way that promotes emotional regulation and helps develop skills to become more emotionally agile. Studies cited by the Professional Association of Therapeutic Horsemanship International show that working with horses can be particularly powerful for trauma survivors, as it requires presence, awareness, and authentic connection.

Yoga and Mindfulness: Our yoga studio offers classes that help guests connect mind and body while learning techniques for managing challenging emotions and nurturing inner peace and balance. These practices are particularly valuable for trauma survivors learning to feel safe in their own bodies.

The 12-Step Foundation of Trauma-Informed Care

As the world’s first 12-Step treatment center, established in 1939, High Watch has always understood that recovery requires addressing the whole person—mind, body, and spirit. Research published in the journal Addiction and reported by the NIH National Library of Medicine found that 12-Step facilitation approaches are highly effective for achieving sustained abstinence.

The 12 Steps themselves provide a trauma-informed framework:

Steps 1-3 help individuals move from the isolation often created by trauma to connection with others and a Higher Power as they understand it.

Steps 4-9 involve examining past experiences and relationships, making amends where appropriate, and releasing shame—all essential processes for trauma healing recognized by trauma experts at the International Society for Traumatic Stress Studies.

Steps 10-12 provide ongoing practices for maintaining wellness and helping others, creating purpose beyond pain.

Our Fourth Step Workshop, led by “Big Book Bill” for over two decades, creates a “structured environment where individuals can safely explore their past in a supportive space”—exactly what trauma survivors need when engaging in deep personal inventory work. Learn more about our approach to 12-Step programming.

Addressing Co-Occurring Mental Health Conditions

The National Institute of Mental Health reports that trauma frequently leads to co-occurring psychiatric conditions such as depression, anxiety, and bipolar disorder. At High Watch, our board-certified psychiatrist and clinical team provide comprehensive treatment that addresses both substance use and mental health issues simultaneously. This integrated approach recognizes that trauma, addiction, and mental health challenges are deeply interconnected and cannot be treated in isolation.

According to SAMHSA’s report on co-occurring disorders, integrated treatment significantly improves outcomes for individuals with both substance use and mental health disorders.

Why Abstinence Matters in Trauma Recovery

As explained in our family education materials, High Watch encourages complete abstinence from all mood-altering substances. For trauma survivors, this approach is particularly important. Substance use, even if it seems “controlled,” can:

Prevent the processing of traumatic memories
Interfere with the development of healthy coping skills
Trigger the same brain pathways associated with addiction
Undermine the therapeutic work being done

Research from NIDA supports abstinence-based approaches for creating the neurological stability necessary for trauma processing.

“While one does not choose the illness, one does choose treatment and must make a daily commitment to applying the treatment plan,” our materials note. This commitment to abstinence creates the clear, stable foundation necessary for trauma healing to occur.

Creating a Supportive Environment for Healing

High Watch’s campus itself supports trauma recovery. Our facilities include:

The historic Mother House chapel, offering a space for quiet reflection and spiritual connection
Beautiful natural surroundings with access to nature hikes in the scenic Litchfield Hills
Comfortable accommodations designed to feel safe and homelike
Nutritious meals prepared in our renowned kitchen, recognizing that proper nutrition supports both physical and emotional healing
Access to our working farm at Joy Farm, providing opportunities for therapeutic engagement with nature and animals

The Environmental Protection Agency’s research confirms that natural environments contribute significantly to mental health and healing.

Family Involvement in Trauma-Informed Care

We recognize that addiction and trauma affect entire families. Our family treatment and education workshops help loved ones understand:

How trauma contributes to substance use disorder
Signs and symptoms to watch for in recovery
How to provide support without enabling
The importance of their own healing journey

Al-Anon Family Groups and other resources provide continued support for families navigating the impact of trauma and addiction.

As we remind families: “You are not responsible for the behaviors associated with your loved one’s illness,” but you can learn to “implement and maintain healthy boundaries” while offering compassionate support.

The Continuum of Trauma-Informed Care

Trauma healing doesn’t happen overnight. High Watch offers a comprehensive continuum of care that allows adequate time for processing and integration:

Detoxification: Medical supervision ensures safe withdrawal from substances in a comfortable, dignified setting.

Residential Treatment: Our intensive residential program provides the initial safety and structure needed to begin trauma work, with daily clinical programming, individual therapy, group work, and 12-Step coaching.

The Hilltop PHP: This partial hospitalization program allows continued therapeutic work while practicing new skills in a home-like environment. Guests live off-campus in High Watch residences and return to our campus daily for programming.

Intensive Outpatient Program: Our online intensive outpatient program allows guests who have completed residential treatment to maintain connection with High Watch while transitioning home, meeting virtually three times per week for continued trauma-focused work.

Extended Care Program: For those who need additional time, our extended care offers continued therapeutic support and trauma-focused work in a highly supportive, structured sober environment on our campus.

Research from the National Institute of Drug Abuse confirms what we see daily: “good outcomes are contingent on adequate treatment length. Generally, for residential or outpatient treatment, participation for less than 90 days is of limited effectiveness, and treatment lasting significantly longer is recommended for maintaining positive outcomes.”

For trauma survivors, this extended timeline is particularly crucial, as rushing the healing process can lead to re-traumatization and relapse.

Hope for Healing

Perhaps the most important aspect of trauma-informed care is the message it sends: Your trauma matters. Your experiences are valid. Healing is possible.

At High Watch, we’ve witnessed countless individuals transform their lives by addressing the trauma underlying their addiction. One guest reflected: “I wasn’t sure when I arrived if I would do the program, now I am positive I have a new chance to make the years I have left to be sober, useful and enjoyable. I am very lucky to have spent three weeks at High Watch.”

Read more guest testimonials to hear about recovery experiences at High Watch.

Moving Forward: Maintaining Remission at Home

As guests prepare to leave High Watch, we help them develop plans for maintaining trauma-informed care in their ongoing recovery:

Continuing with trauma-focused therapy in their home community
Attending 12-Step meetings that feel emotionally safe
Implementing self-care practices learned during treatment
Recognizing and managing trauma triggers
Building a support network that understands trauma and recovery

We remind both guests and families: “Recovery life requires active engagement in ongoing treatment and anonymous support group meetings. Residential treatment is the courageous beginning of a life journey.”

Our alumni programs and support help maintain connection with the High Watch community during ongoing recovery.

Getting Started

If you or a loved one is struggling with substance use disorder and trauma, help is available. High Watch’s trauma-informed approach combines compassionate clinical care with the time-tested spiritual teachings of the 12 Steps, creating a powerful path to healing.

Our admissions team is available to answer questions about our trauma-informed program and help determine the right level of care. We accept commercial insurance and work with families to make treatment accessible.

Call us today at 860-321-6143 to begin your journey toward recovery and healing. You can also contact us online for more information.

For professionals seeking to refer clients, please visit our referring professionals page.

Additional Resources:

High Watch Recovery Center is located at 62 Carter Road in Kent, Connecticut, on 300 wooded acres in the beautiful Litchfield Hills. As the world’s first 12-Step treatment center, established in 1939, we honor our rich history while continuously integrating the latest evidence-based practices in addiction medicine and trauma treatment.

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