COPE-A is a psychological therapy that aims to help young people (aged 12-25 years) cope with negative thoughts or feelings that they may experience following traumatic events while also addressing problems with alcohol and/or other drug use.

COPE-A is based on an evidence-based therapy for adults called COPE, that has been adapted for use among adolescents and young adults. COPE has been found to be an effective treatment for adults when compared to other treatments in trials conducted in Australia, the United States and Sweden^1-6, and is recommended by the American Psychological Association as a first-line treatment for people experiencing post-traumatic stress disorder (PTSD) who are also experiencing problems related to their alcohol or other drug use⁷.

COPE-A was first trialled among young people in Sydney, Australia, in 2018. This initial study compared outcomes for young people who were randomly allocated to receive either COPE-A or supportive counselling. The study found that participants who started COPE-A therapy experienced significantly greater reductions in their PTSD symptoms during treatment than those who received supportive counselling⁸.

The University of Sydney is currently conducting a further trial of COPE-A to help us learn more about what psychological treatments work best for young people aged 12-25 years who are using alcohol or other drugs and are having a tough time coping after something traumatic has happened to them.

The research is funded by the Medical Research Future Fund (MRFF) and approved by the Sydney Children’s Hospitals Network Human Research Ethics Committee (2024/ETH01050).

References

1. Mills, K. L., Teesson, M., Back, S. E., Brady, K. T., Baker, A. L., Hopwood, S., Sannibale, C., Barrett, E. L., Merz, S., Rosenfeld, J., & Ewer, P. L. (2012). Integrated exposure-based therapy for co-occurring posttraumatic stress disorder and substance dependence: A randomized controlled trial. JAMA, 308(7), 690–699. https://doi.org/10.1001/jama.2012.9071
2. Ruglass, L. M., Lopez-Castro, T., Papini, S., Killeen, T., Back, S. E., & Hien, D. A. (2017). Concurrent treatment with prolonged exposure for co-occurring full or subthreshold posttraumatic stress disorder and substance use disorders: A randomized clinical trial. Psychotherapy and psychosomatics, 86(3), 150-161. https://doi.org/10.1159/000462977
3. Back, S. E., Killeen, T., Badour, C. L., Flanagan, J. C., Allan, N. P., Ana, E. S., Lozano, B., Korte, K. J., Foa, E. B., & Brady, K. T. (2019). Concurrent treatment of substance use disorders and PTSD using prolonged exposure: A randomized clinical trial in military veterans. Addictive Behaviors, 90, 369-377. https://doi.org/10.1016/j.addbeh.2018.11.032
4. Norman, S. B., Trim, R., Haller, M., Davis, B. C., Myers, U. S., Colvonen, P. J., Blanes, E., Lyons, R., Siegel, E. Y., Angkaw, A. C., Norman, G. J., & Mayes, T. (2019). Efficacy of Integrated Exposure Therapy vs Integrated Coping Skills Therapy for Comorbid Posttraumatic Stress Disorder and Alcohol Use Disorder: A Randomized Clinical Trial. JAMA Psychiatry, 76(8), 791–799. https://doi.org/10.1001/jamapsychiatry.2019.0638
5. Persson, A., Axén, Å., Capusan, A. J., Magnusson, Å., & Heilig, M. (2025). Concurrent Treatment of Posttraumatic Stress Disorder and Alcohol Use Disorder in Women: A Randomized Clinical Trial. JAMA Network Open, 8(7), e2521087. https://doi.org/10.1001/jamanetworkopen.2025.21087
6. Back, S. E., Jarnecke, A. M., Norman, S. B., Zaur, A. J., & Hien, D. A. (2024). State of the Science: Treatment of comorbid posttraumatic stress disorder and substance use disorders. Journal of Traumatic Stress, 37(6), 803–813. https://doi.org/10.1002/jts.23049
7. American Psychological Association (2025). APA Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder (PTSD) in Adults. https://www.apa.org/about/policy/guideline-ptsd-in-adults.pdf
8. Dobson O, Peach N, Cassar J, Isik A, Bezzina L, Schollar-Root ), Kihas I, Dobinson K, Cobham V, Barrett E, Perrin S, Bendall S, Back S, Brady K, Milne B, Ross, Teesson M, Mills KL. Temporal sequencing of symptom change in young people receiving treatment for posttraumatic stress disorder and substance use: Secondary findings from a randomised controlled trial. European Journal of Psychotraumatology. https://doi.org/10.1080/20008066.2026.2630609.