Multisite randomized trial of behavioral interventions for women with co-occurring PTSD and substance use disorders.

This article reports on the outcomes of CTN-0015, a protocol that compared the effectiveness of the Seeking Safety group, cognitive-behavioral treatment for substance use disorder and posttraumatic stress disorder (PTSD), to an active comparison health education group (Women’s Health Education (WHE)) within the National Drug Abuse Treatment Clinical Trials Network. For the study, 353 women were randomized to received 12 sessions of Seeking Safety (M = 6.2 sessions) or WHE (M = 6.0 sessions) with follow-up assessment at 1 week, 3, 6, and 12 months posttreatment. Primary outcomes were measured by the Clinician Administered PTSD Scale (CAPS) , the PTSD Symptom Scale-Self Report (PSS-SR), and a substance use inventory (self-reported abstinence and percentage of days of use over 7 days). Intention-to-treat analysis showed large, clinically significant reductions in CAPS and PSS-SR symptoms (d = 1.94 and 1.12, respectively) but no reliable difference between conditions. Substance use outcomes were not significantly different over time between the the two treatments and at follow-up showed no significant change from baseline.

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.

Related protocols: CTN-0015