by Bonnie Eissner
What is the relationship between early-life trauma and
addiction? What treatments are most effective for people, particularly poor
women and families who are struggling with these often-linked challenges? How
can these treatments be implemented in community clinics?
These are questions that Denise Hien, Ph.D., a professor at
the Gordon F. Derner Institute of Advanced Psychological Studies, has been
seeking to answer throughout her career. A researcher, clinician and teacher,
her overarching aim is to “understand how early-childhood abuse evolves over
the course of life and intersects with substance use and other kinds of
problems.”
Dr. Hien has noted that “as many as 80 percent of women
seeking treatment for drug abuse report lifetime histories of sexual and/or
physical assault.” Through her clinical work with women and families in New
York City’s Harlem, Morningside Heights and Washington Heights neighborhoods,
as well as her national research, Dr. Hien works to improve treatment outcomes
for patients who struggle with trauma and substance abuse.
Since 2002, Dr. Hien has been a co-principal investigator
with the National Institute on Drug Abuse (NIDA) Clinical Trials Network
Greater New York Node. The network is a federal initiative to link researchers
and community-based treatment centers to allow real-world studies of drug
treatments. In a recent NIDA-sponsored study, for example, Dr. Hien and her
team examined what happened when an antidepressant medication was added to a cognitive
behavioral therapy treatment for PTSD and alcohol use disorders. The
researchers found that the drug combined with the therapy, known as Seeking
Safety, was significantly more effective at treating PTSD and alcohol abuse
than therapy alone.
“You might think, ‘Well isn’t that obvious? That’s what
people do, they give [patients] medication and they give them therapy,” Dr. Hien
said. “But nobody really knows if it works. So here’s a trial that showed that
it really works.”
In another NIDA-sponsored project, Dr. Hien and her colleagues
worked with drug counselors across the country to see if they could safely and
effectively conduct trauma treatment groups with their clients. “The answer was
yes they could, so it provided support for being able to translate treatment
into the real world,” Dr. Hien said.
Having conducted numerous clinical trials, Dr. Hien is
intimately familiar with their advantages as well as their shortcomings. “It’s
hard to show big effects with relatively small sample sizes,” she pointed out,
adding, “And then there’s the problem of ending up testing what amount to short-term
treatments for long-term problems.”
How can these challenges be overcome? For Dr. Hien, the
short answer is big data. She is now applying for a grant to create a large data
set from more than 20 clinical trials that tested the efficacy of medication
and psychotherapy in treating PTSD and substance use disorders. Dr. Hien
explained that with information on thousands of patients, “you can ask
questions that are more nuanced when it comes to trying to advance the science
of treatment.”
Dr. Hien teaches master’s- and doctorate-level psychology
courses at Adelphi and says that her work in the field amplifies what she can
offer students in the classroom.
“My clinical work and my research inform my teaching because
they’re what I’m passionate about, and usually I’m teaching things that link up
to these topics,” she said.
This article is from the spring 2015 issue of Erudition.
This article is from the spring 2015 issue of Erudition.
