Synergy between Seeking Safety and twelve-step affiliation on substance use outcomes for women.

The Recovery Management paradigm provides a conceptual framework for the examination of joint impact of a focal treatment and post-treatment service utilization on substance abuse treatment outcomes. This study tested this framework by examining the interactive effects of a treatment for comorbid PTSD and substance use, Seeking Safety, and post-treatment Twelve-Step Affiliation (TSA) on alcohol and cocaine use. Data from 363 women in a six-site, randomized controlled effectiveness trial within the National Drug Abuse Treatment Clinical Trials Network (CTN-0015, “Women’s Treatment for Trauma and Substance Use Disorders”) were analyzed under latent class pattern mixture modeling. LCPMM was used to model variation in Seeking Safety by TSA interaction effects on alcohol and cocaine use. Significant reductions in alcohol use among women in Seeking Safety (compared to health education) were observed; women in the Seeking Safety condition who followed up with TSA had the greatest reductions over time in alcohol use. Reductions in cocaine use over time were also observed but did not differ between treatment conditions nor were there interactions with post-treatment TSA.

Conclusions: This study extends current knowledge on treating conditions with a high risk for relapse, such as PTSD and comorbid SUDs, and the adjunctive benefits of TSA for extending treatment effects. Findings underscore the importance of maintaining an ongoing connection to some form of recovery services and the need for continued social support, particularly among a population of women who are most vulnerable, and, more specifically, suggest that providers may consider the use of TSA in combination with Seeking Safety to promote potential synergistic effects.

Related protocols: CTN-0015