A Randomized Controlled Trial for Veterans with PTSD and Substance Use Disorder: Creating Change versus Seeking Safety

@article{Najavits2018ARC,
  title={A Randomized Controlled Trial for Veterans with PTSD and Substance Use Disorder: Creating Change versus Seeking Safety},
  author={Lisa M Najavits and Karen E. Krinsley and Molly E. Waring and Matthew W. Gallagher and Christopher Skidmore},
  journal={Substance Use \& Misuse},
  year={2018},
  volume={53},
  pages={1788 - 1800}
}
ABSTRACT Background: Posttraumatic stress disorder (PTSD) and substance use disorder (SUD) co-occur in military veterans and other populations. Objective: To conduct a randomized controlled trial to compare a new past-focused treatment (Creating Change; CC), to a well-established, evidence-based present-focused treatment for PTSD/SUD (Seeking Safety; SS), on symptoms of both disorders. CC guides patients to process the past through exploration of PTSD/SUD life themes and memories whereas SS… 
A multisite randomized controlled trial of Seeking Safety vs. Relapse Prevention Training for women with co-occurring posttraumatic stress disorder and substance use disorders
TLDR
To test the efficacy of Seeking Safety plus treatment as usual (TAU) in female outpatients with PTSD and SUD compared to Relapse Prevention Training (RPT) plus TAU and TAU alone, and to investigate further variables, Seeking Safety and RPT showed greater reductions thanTAU alone in other domains of psychopathology and substance use outcomes respectively.
Is Integrated CBT Effective in Reducing PTSD Symptoms and Substance Use in Iraq and Afghanistan Veterans? Results from a Randomized Clinical Trial
This study is the first to examine integrated cognitive behavioral therapy (ICBT) in a sample of military veterans with co-occurring posttraumatic stress disorder (PTSD) and substance use disorders
PTSD/Substance Use Disorder Comorbidity: Treatment Options and Public Health Needs
TLDR
PTSD research is at an early stage and there is a need for methodology that quantifies “level of burden” (patients’ socioeconomic disadvantages) across trials, and there are two broad types of models: those that originated in the PTSD field versus the SUD field, stronger on public health factors and more feasible in SUD settings.
Efficacy and acceptability of interventions for co-occurring PTSD and SUD: A meta-analysis
A systematic review and meta-analysis of psychological interventions for comorbid post-traumatic stress disorder and substance use disorder
ABSTRACT Background The psychological treatment of comorbid post-traumatic stress disorder (PTSD) and substance use disorder (SUD) is clinically challenging, and outcomes are often poor. Objective
Motives for substance use and 6-month substance use outcomes among detoxification patients with a history of physical or sexual abuse or posttraumatic stress disorder.
Trauma-exposed individuals with a history of physical or sexual abuse or documented posttraumatic stress disorder (PTSD) diagnosis may use substances to address trauma-related symptoms. However, the
Management of Post-traumatic Stress Disorder in Veterans and Military Service Members: A Review of Pharmacologic and Psychotherapeutic Interventions Since 2016
TLDR
The development of new research-based evidence in the treatment of PTSD, both pharmacologic and psychotherapeutic, is needed and likely to necessitate frequent updates and re-evaluations of clinical practice guidelines.
Trauma-Informed Parenting Education Support Groups for Mothers in Substance Abuse Recovery
TLDR
Paired samples t tests of intention-to-treat data showed a statistically significant decrease in self-reported symptoms of stress and substance cravings and increases in positive behaviors and parenting self-efficacy.
Therapeutic alliance in psychological therapy for PTSD: A systematic review and meta-analysis.
TLDR
This is the first review to demonstrate that therapeutic alliance is a consistent predictor of PTSD outcomes, in both in-person and remote therapies, and the effect appears at least as strong as in other populations.
...
1
2
...

References

SHOWING 1-10 OF 89 REFERENCES
Multisite randomized trial of behavioral interventions for women with co-occurring PTSD and substance use disorders.
TLDR
Study results do not favor Seeking Safety over WHE as an adjunct to substance use disorder treatment for women with PTSD and reflect considerable opportunity to improve clinical outcomes in community-based treatments for these co-occurring conditions.
Trauma-focused treatment for posttraumatic stress disorder combined with CBT for severe substance use disorder: a randomized controlled trial
TLDR
Preliminary evidence is provided that adding a trauma-focused treatment on to standard SUD treatment may be beneficial, and a general reduction of SUD symptoms for both TAU + SWT and TAU.
Pilot study of Creating Change, a new past-focused model for PTSD and substance abuse.
TLDR
Significant improvements were found in multiple domains including some PTSD and trauma-related symptoms; broader psychopathology; daily life functioning; cognitions related to PTSD; coping strategies; and suicidal ideation; effect sizes were consistently large, including for both alcohol and drug problems.
Seeking Safety Plus Exposure Therapy: An Outcome Study on Dual Diagnosis Men
TLDR
This study appears to be the first outcome trial to address a sample of civilian men with PTSD and SUD using manualized psychosocial treatment, and evaluates a novel combination treatment, Seeking Safety plus Exposure Therapy-Revised.
Integrated exposure-based therapy for co-occurring posttraumatic stress disorder and substance dependence: a randomized controlled trial.
TLDR
Among patients with PTSD and substance dependence, the combined use of COPE plus usual treatment, compared with usual treatment alone, resulted in improvement in PTSD symptom severity without an increase in severity of substance dependence.
Helping vulnerable populations: a comprehensive review of the treatment outcome literature on substance use disorder and PTSD.
TLDR
This first-generation of PTSD/SUD research addresses complex samples excluded from "gold standard" PTSD-alone literature, and shows positive outcomes on multiple domains, including Seeking Safety (SS), the most studied model.
Randomized controlled trial of cognitive behaviour therapy for comorbid post-traumatic stress disorder and alcohol use disorders.
TLDR
Individuals with severe and complex presentations of coexisting post-traumatic stress disorder (PTSD) and alcohol use disorders (AUD) can derive substantial benefit from cognitive behaviour therapy targeting AUD, with greater benefits associated with exposure for PTSD.
...
1
2
3
4
5
...