Experiences of female substance users with trauma-sensitive yoga as complementary support in addiction treatment

Background. Research shows that the trajectories of female substance users are characterised by several specific needs and concerns regarding treatment. Based on qualitative research and fully in line with the post-modern approach of substance use, alcohol and drug treatment programmes should ideally integrate a holistic approach, focusing on healing both body and mind. 
As adjunctive therapy, yoga is commonly integrated into addiction treatment. However, conventional yoga practice does not intentionally address the underlying trauma that many with addictive use disorders have experienced. Moreover, PTSD is a common and chronic psychiatric disorder impacting women at a much higher rate than men (11,7% and 4,0% respectively). Furthermore, a vast majority of substance-abusing women report sexual, physical, and/or emotional abuse. Experientially, women with complex trauma histories often feel disconnected from their bodies and struggle to feel safe in their own body. 
Considering the growing body of evidence highlighting the significant role trauma plays in the development and exacerbation of SUD, it is imperative that treatment approaches address trauma and addiction simultaneously. 
In this study, the authors explore the interplay of trauma and SUD among women, define Trauma Center Trauma-Sensitive Yoga (TCTSY), discuss how TCTSY is being implemented in both an outpatient and a residential service for addiction treatment, and report how women experience it. This study aims to (1) gauge the impact of therapeutic yoga classes upon the mood state of people with SUD and (2) explore the perceived benefits of TCTSY.
Methods. Six participants who attended the classes were interviewed using in-depth interviews. Participant observation was used as a complementary method. 
Results. Participants attributed a positive value to TCTSY, primarily experiencing an increase in calmness and self-esteem. For five of the six participants, attending the TCTSY sessions resulted in both mental and physical rest. Five of the six participants reported that attending the TCTSY sessions resulted in an increased self-esteem, and some participants believed that attending the TCTSY sessions resulted in enhanced interoception. In addition, participants named autonomy, safety, sources of rest, social contact and structure as pleasant elements of TCTSY.
Conclusions. This research shows that TCSTY can be valuable as complementary support in addiction recovery and can be done in both outpatient and residential contexts. However, it is necessary to stress that, despite the positive findings and potential relevance TCTSY seems to have within (broad) addiction care, it does not act as a substitute for other interventions. It is therefore recommended to approach this TCTSY implementation as an opportunity for integrative support within addiction care. Finally, when implementing TCTSY in a facility, one should pay attention to some important preconditions, such as location and organisation.