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

The results of protocol CTN-0015, “Women’s Treatment for Trauma and Substance Use Disorders,” found that the intervention, “Seeking Safety,” a structured cognitive-behavioral treatment that addresses trauma/post-traumatic stress disorder and substance abuse, was no more effective at reducing PTSD symptom severity than Women’s Health Education, the control curriculum (which did not specifically address PTSD). There were also no significant changes in baseline to one-year follow-up for either group in terms of substance use.

These results were contrary to prior research and difficult to interpret. This commentary article offers several possible explanations. One possible conclusion is that Seeking Safety does not have specific elements that address PTSD any more effectively than Women’s Health Education, which supposedly had none. As such, the study conclusions are consisted with a large literature where failures to differentiate active psychotherapy interventions are common. A second possibility is that Women’s Health Education contains as-yet-unidentified active ingredients as effective as those in Seeking Safety at treating symptoms of PTSD. Additional research is required to determine the effectiveness of Seeking Safety and other trauma/PTSD interventions in treating co-occurring PTSD and substance abuse within the primary substance abuse treatment system.

Related protocols: CTN-0015