# Promoting Retention in Opioid Treatment among Women Experiencing Intimate Partner Violence: A Novel Stepped Care Model Targeting PTSD

> **NIH NIH R61** · YALE UNIVERSITY · 2023 · $1,271,474

## Abstract

Abstract
Women with opioid use disorder (OUD) are disproportionately impacted by intimate partner violence (IPV) and
PTSD, with up to 78% of women receiving medication for opioid use disorder (MOUD) treatment experiencing
IPV in the past 6 months. Regardless of PTSD diagnosis, 72%-78% of W-IPV experience clinically significant
PTSD-related impairment in functioning. PTSD reduces treatment retention. Interventions effectively target
PTSD to reduce substance, but many are not advised for IPV because they are exposure-based therapies for
trauma that occurred in the past – not for trauma that is ongoing, as with IPV. Integrated interventions for other
health conditions improve outcomes for MOUD treatment, yet no evidence-based treatments exist that
integrate a much-needed focus on IPV and PTSD into MOUD treatment. Present-Centered Therapy+ (PCT+)
and Helping to Overcome PTSD through Empowerment (HOPE) are two evidence-based, manualized
behavioral interventions designed for women experiencing IPV (W-IPV) to reduce PTSD symptoms and other
trauma-related outcomes. PCT+ focuses on helping W-IPV cope with current stressors that arise from their
traumatic experiences; it can be delivered in 8 sessions by nonclinical, professional staff who may be more
available and affordable in MOUD treatment settings. Some women may not respond to PCT+ alone and need
additional treatment. HOPE is an IPV-specific cognitive behavioral therapy delivered in 16 sessions by
Master’s level therapists and incorporates empowerment and stabilization treatment models. Our innovative
approach packages these two interventions in a stepped care model to create PCT+2HOPE. This phased
study conducted in three MOUD treatment settings in the United States northeast will be guided by the
Exploration, Preparation, Implementation, and Sustainment (EPIS) framework. We will explore, prepare for,
and then implement a randomized controlled trial to evaluate PCT+2HOPE versus treatment as usual while
collecting data relevant for informing future sustainment. We will elicit input from W-IPV as well as direct
service and supervisory staff to inform: protocols for systematically identifying IPV in OUD treatment settings,
processes for referral to domestic violence service providers, and adaptation of the PCT+ and HOPE
interventions (R33 phase). Then, we will evaluate the impact of PCT+2HOPE on promoting retention in MOUD
treatment while improving secondary outcomes (e.g, PTSD, IPV, client-defined recovery) (R61 phase). We will
explore whether the effectiveness of the interventions differ across and within racial and ethnic groups and
based on SDOH. Building on established partnerships, our interdisciplinary study team includes community-
based OUD and domestic violence service providers, and academic partners with expertise in IPV, PTSD and
OUD-related care; addiction medicine; clinical trials with adaptive designs; community-partnered research;
health disparities; and implementation science. Our stu...

## Key facts

- **NIH application ID:** 10812139
- **Project number:** 1R61DA059895-01
- **Recipient organization:** YALE UNIVERSITY
- **Principal Investigator:** E. Jennifer Edelman
- **Activity code:** R61 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $1,271,474
- **Award type:** 1
- **Project period:** 2023-09-30 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10812139

## Citation

> US National Institutes of Health, RePORTER application 10812139, Promoting Retention in Opioid Treatment among Women Experiencing Intimate Partner Violence: A Novel Stepped Care Model Targeting PTSD (1R61DA059895-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10812139. Licensed CC0.

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