Synthesizing outcomes in evidence-based practices for women with trauma and addictions.

Epidemiologic studies have found that trauma-related disorders are ubiquitous among women in treatment for addictions. Evidence-based practices (EBP) for trauma among those with addictions have brought the field to an important stage: examining mechanistic questions such as how, for whom and when EBPs work best and learning how to implement EBPs in community treatment settings. The National Drug Abuse Treatment Clinical Trials Network “Women and Trauma” study, protocol CTN-0015, has contributed to this body of knowledge. With over 15 publications, none has yet provided an integrative overview of the findings. This presentation examines the contribution of this landmark multi-site psychotherapy trial through a review of primary and secondary analyses that highlight important aspects of patient centered outcomes.

From 2004-2005 in seven treatment programs, the study randomized 353 women into one of two 6-week treatment groups in addiction to treatment-as-usual: 1) Seeking Safety, a treatment for substance abuse and trauma, or 2) Women’s Health Education curriculum comparison group. Assessments were administered at baseline, weekly in treatment, and 3-, 6-, and 12-months post-treatment. In addition to primary and secondary findings, important mediators (e.g., therapeutic alliance, PTSD severity), moderators (e.g., participation in self-help recovery), individual characteristics (e.g., recovery management) and implementation issues (e.g., safety, racial/ethnic client-counselor matching, treatment participation) are discussed from both research and clinical perspectives.

Conclusions: In an era of patient-centered outcomes, new methods and creative analytic techniques are essential to maximize findings from clinical trials. Synthesizing the analyses from the Women and Trauma studies is presented as a model for how to approach interpreting research outcomes relevant to personalized medicine.

Related protocols: CTN-0015