For a veteran with PTSD and comorbid substance use, what integrated nursing approach supports recovery?

• A. Only pharmacotherapy with no psychotherapy.
• B. Trauma-informed care, evidence-based therapies, coordinate with VA resources, monitor withdrawal, promote medication adherence, provide peer support, screen for TBI, and ensure safety planning.
• C. Isolate veteran from peers.
• D. Avoid discussing trauma history.

Answer: (B)

Integrated, trauma-informed care blends pharmacotherapy with evidence-based psychotherapy, coordinated with VA resources, and includes ongoing withdrawal monitoring, medication adherence support, peer connections, TBI screening, and safety planning. This approach directly addresses how PTSD and substance use interlock, while recognizing the pervasive impact of trauma on engagement and functioning. Evidence-based therapies for PTSD, such as processing-focused and exposure-based therapies, are most effective when paired with strategies that manage cravings and withdrawal, support adherence, and are delivered within a coordinated care framework. Coordinating with VA resources ensures access to specialized programs, case management, and seamless care across medical, mental health, and addiction services, which is crucial for a veteran with complex needs. Monitoring withdrawal helps ensure safety and reduces relapse risk; promoting medication adherence sustains symptom relief and stabilizes mood and sleep; peer support provides validation and motivation; screening for traumatic brain injury informs tailoring of therapy and safety planning; and safety planning offers concrete steps and resources for crisis moments. Relying solely on medications, isolating the patient, or avoiding trauma discussions undermines recovery by missing this comprehensive, collaborative approach.