# Trauma-informed Treatment for Adults: RCT of a Strength and Skills-Based Intervention to Decrease Apache Substance Use and Suicide

> **NIH NIH S06** · WHITE MOUNTAIN APACHE TRIBE · 2021 · $185,643

## Abstract

PROJECT SUMMARY 
Native American (NA) studies focused on Adverse Childhood Events (ACEs) have found 
associations with alcohol, drug, and suicidal risk; and NA studies targeting alcohol and drug 
abuse and suicide have identified ACEs as risk factors. The goal of the Apache-JHU NARCH 
trauma research project is to: 1) better understand the types, meanings and impact of ACEs, 
and 2) how to effectively reduce the impact of these experiences in Apache adults with alcohol, 
drug and suicide risks. We will use a rigorous mixed-methods, community-based approach 
combining qualitative methods with a RCT to adapt and test a strength- and skills-based 
intervention, “My Pathway to Healing.” My Pathway to Healing is based on a trauma-informed, 
common elements intervention that has a robust evidence-base internationally, and will be 
delivered using a task-shifting approach by culturally embedded Apache Community Mental 
Health Specialists (CMHS). The specific aims are to: 1) to characterize the meaning and impact 
of ACES and identify key resilience factors for Apache adults ages 18-65 using Free Listing and 
In-Depth Interviews with N=30 key stakeholders. 2) To adapt a common elements intervention, 
My Pathway to Healing, based on Aim 1 findings and CAB input for piloting by Apache CMHS 
with N=10 Apaches ages 18-65 with recent suicide ideation and/or substance use. 3) To test the 
effectiveness of My Pathway to Healing using a wait-list controlled RCT with N=104 Apache 
adults ages 18-65 with recent suicide ideation and/or binge substance use. We hypothesize that 
participants will experience greater reductions in risk (trauma symptoms, depression) and 
increases in protective factors (hopefulness, communal mastery, functioning) related to 
substance use and suicidal behavior vs. controls at 6 months post-intervention. 4) To train and 
mentor 8 NA junior investigators in the trauma informed intervention, mixed methods research, 
data management, and ethical conduct of research. The Apache-JHU NARCH trauma research 
project builds on several successful rounds of NARCH funding, culminating in two Apache Co- 
Investigators completing their Master's degrees, enrolling in part-time doctoral programs 
in mental health, and being empowered to provide local clinical supervision for this 
study. This project will address critical next steps in trauma-informed care research by 
examining how ACEs and other trauma affect alcohol abuse, drug abuse, and suicidality—some 
of the largest health disparities for NAs. The use of a CMHS model will extend the reach, impact 
and scalability of culturally appropriate and evidence-based trauma-informed care for adults at 
risk of suicide in a community-based setting.

## Key facts

- **NIH application ID:** 10271250
- **Project number:** 5S06GM127981-04
- **Recipient organization:** WHITE MOUNTAIN APACHE TRIBE
- **Principal Investigator:** MARIDDIE J CRAIG
- **Activity code:** S06 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $185,643
- **Award type:** 5
- **Project period:** 2018-09-20 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10271250

## Citation

> US National Institutes of Health, RePORTER application 10271250, Trauma-informed Treatment for Adults: RCT of a Strength and Skills-Based Intervention to Decrease Apache Substance Use and Suicide (5S06GM127981-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10271250. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*