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Racial/Ethnic Match and Treatment Outcomes for Women with PTSD and Substance Use Disorders Receiving Community-Based Treatment.

Community Mental Health Journal 2014;50(7):811-822. [doi: 10.1007/s10597-014-9732-9]

Lesia M. Ruglass, PhD (City College of New York, GNY Node), Denise A. Hien, PhD (New York State Psychiatric Institute, GNY Node), Mei-Chen Hu, PhD (Columbia University, GNY Node), Aimee N. C. Campbell, PhD, MSW (Columbia University, GNY Node), Nathilee A. Caldeira, PhD (Columbia University, GNY Node), Gloria M. Miele, PhD (Columbia College of Physicians and Surgeons, GNY Node), Doris F. Chang, PhD (New School for Social Research).

This study examined the relationship between racial/ethnic match and treatment outcomes for 224 women who participated in a National Drug Abuse Treatment Clinical Trials Network (CTN) study of group treatments for posttraumatic stress disorder (PTSD) and substance use disorders, "Women's Treatment for Trauma and Substance Use Disorders" (CTN-0015). Generalized estimating equations were used to examine the effect of client-therapist racial/ethnic match on outcomes.

Results revealed racial/ethnic match was not significantly associated with session attendance. There was a significant three-way interaction between client race/ethnicity, baseline level of PTSD symptoms, and racial/ethnic match on PTSD outcomes. White clients, with severe PTSD symptoms at baseline, who attended treatment groups where they were matched with their therapist, had greater reductions in PTSD symptoms at follow-up than their counterparts who were racially/ethnically mismatched with their group therapist. Racial/ethnic match did not confer additional benefits for black clients in terms of PTSD outcomes; reasons for this are discussed. Racial/ethnic match interacted with baseline substance use to differentially influence substance use outcomes at follow-up for all women.

Conclusions: Overall, these findings revealed the complexity of racial/ethnic matching between client and therapist and its impact, particularly within a group treatment context. While racial/ethnic matching may provide, in some circumstances, a context that facilitates understanding, enhances trust, and strengthens the alliance; under other conditions, racial/ethnic matching may not confer additional benefits. These findings highlight the need for further examinations into individual and subgroup differences in the benefits of racial/ethnic matching. (Article (Peer-Reviewed), PDF, English, 2014)

Keywords: African Americans | Co-occurring disorders | CTN platform/ancillary study | Gender-specific interventions | Minority groups | Post-traumatic stress disorder (PTSD) | Seeking Safety program | Therapeutic alliance | Trauma | Treatment compliance | Women | Women's Health Education program | Community Mental Health Journal (journal)

Document No: 1063, PMID: 24817203, PMCID: PMC4175006.

Submitted by CTN Dissemination Librarians, 5/13/2014.

AUTHORS SEARCH LINK
Caldeira, Nathilee A. search
Campbell, Aimee N. C. search mail
Chang, Doris F. search
Hien, Denise A. search mail
Hu, Mei-Chen search
Miele, Gloria M. search mail
Ruglass, Lesia M. search mail
PROTOCOLS
NIDA-CTN-0015 search www
PARTICIPATING NODES    
Greater New York search www

Supported by a grant from the National Institute on Drug Abuse to the University of Washington Alcohol and Drug Abuse Institute.
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