Does Seeking Safety reduce PTSD symptoms in women receiving physical disability compensation?

This secondary analysis of data from National Drug Abuse Institute Clinical Trials Network protocol CTN-0015, “Women’s Treatment for Trauma and Substance Use Disorders,” investigated the impact of 12 sessions of Seeking Safety (SS) on reducing posttraumatic stress disorder (PTSD) symptoms in a sample of dually diagnosed women with physical disabilities versus nondisabled (ND) women. SS is an evidence-based and widely implemented manualized therapy for PTSD and/or substance use disorder. It is a present-focused model that promotes coping skills and psychoeducation. In CTN-0015, 353 participants with current PTSD and substance use disorder (SUD) were randomly assigned to partial-dose SS or Women’s Health Education (WHE) group therapy conducted in a community-based substance abuse treatment program. The women were categorized as participants with disabilities (PWD; n=20) or ND (n=333) based on the question, “Do you receive a pension for a physical disability?” PTSD was assessed with the Clinician-Administered PTSD Scale (CAPS) at baseline and follow-ups after treatment (1 week, 3 months, 6 months, and 12 months). PWD experienced sustained reductions in PTSD symptoms when treated with SS but not WHE. Indeed, PTSD symptoms of PWD in WHE returned to baseline levels of severity by 12-month follow-up. This pattern of results was not observed among ND women, who sustained improvements on PTSD in both treatment conditions.

Conclusions: These results suggest strong potential for using Seeking Safety to treat PTSD among women with physical disabilities, an intervention that may be particularly relevant for this population by providing a trauma focus without requiring clients to delve into painful traumatic memories and instead offering a present and optimistic focus on coping skills and education. This is a vulnerable population for whom trauma is bound up closely with disability; the finding here, that women with disabilities had better outcomes in the Seeking Safety group than the Women’s Health Education group, speaks to the genuine need to address trauma and PTSD more directly in those with disabilities.

Related protocols: CTN-0015