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Synergy Between Seeking Safety and Twelve-Step Affiliation on Substance Use Outcomes for Women.

Journal of Substance Abuse Treatment 2013;45(2):179-189. [doi: 10.1016/j.jsat.2013.01.015]

Antonio A. Morgan-Lopez, PhD (RTI International), Lissette M. Saavedra, PhD (RTI International), Denise A. Hien, PhD (Columbia University College of Physicians and Surgeons, GNY Node), Aimee N. C. Campbell, MSW, PhD (New York State Psychiatric Institute, GNY Node), Elwin Wu, PhD (Columbia University, GNY Node), Lesia M. Ruglass, PhD (City College of the City of New York, GNY Node).

The Recovery Management paradigm provides a conceptual framework for the examination of joint impact of a focal treatment and post-treatment service utilization on substance abuse treatment outcomes. This study tested this framework by examining the interactive effects of a treatment for comorbid PTSD and substance use, Seeking Safety, and post-treatment Twelve-Step Affiliation (TSA) on alcohol and cocaine use. Data from 363 women in a six-site, randomized controlled effectiveness trial within the National Drug Abuse Treatment Clinical Trials Network (CTN-0015, "Women's Treatment for Trauma and Substance Use Disorders") were analyzed under latent class pattern mixture modeling. LCPMM was used to model variation in Seeking Safety by TSA interaction effects on alcohol and cocaine use. Significant reductions in alcohol use among women in Seeking Safety (compared to health education) were observed; women in the Seeking Safety condition who followed up with TSA had the greatest reductions over time in alcohol use. Reductions in cocaine use over time were also observed but did not differ between treatment conditions nor were there interactions with post-treatment TSA.

Conclusions: This study extends current knowledge on treating conditions with a high risk for relapse, such as PTSD and comorbid SUDs, and the adjunctive benefits of TSA for extending treatment effects. Findings underscore the importance of maintaining an ongoing connection to some form of recovery services and the need for continued social support, particularly among a population of women who are most vulnerable.  More specifically, findings suggest that providers may consider the use of TSA in combination with Seeking Safety to promote potential synergistic effects. (Article (Peer-Reviewed), PDF, English, 2013)

Keywords: Aftercare | Alcohol | Cocaine | Co-occurring disorders | CTN platform/ancillary study | Gender-specific interventions | Post-traumatic stress disorder (PTSD) | Relapse prevention | Seeking Safety program | Trauma | Women | Journal of Substance Abuse Treatment (journal)

Document No: 975, PMID: 23558158, PMCID: PMC4153737.

Submitted by CTN Dissemination Librarians, 4/8/2013

Campbell, Aimee N. C. search mail
Hien, Denise search mail
Morgan-Lopez, Antonio A. search
Ruglass, Lesia M. search
Saavedra, Lissette M. search
Wu, Elwin search
NIDA-CTN-0015 search www
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