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Erschienen in: The Journal of Behavioral Health Services & Research 4/2006

01.10.2006 | Brief Report

Seeking Safety Therapy for Adolescent Girls with PTSD and Substance Use Disorder: A Randomized Controlled Trial

verfasst von: Lisa M. Najavits, PhD, Robert J. Gallop, PhD, Roger D. Weiss, MD

Erschienen in: The Journal of Behavioral Health Services & Research | Ausgabe 4/2006

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Abstract

This randomized, controlled trial evaluated a manualized psychotherapy, Seeking Safety (SS), for posttraumatic stress disorder (PTSD) and substance use disorder (SUD) in adolescent females. To our knowledge, no prior study has evaluated any psychotherapy designed for this population. SS was compared to treatment as usual (TAU) for 33 outpatients, at intake, end-of-treatment, and 3 months follow-up. SS evidenced significantly better outcomes than TAU in a variety of domains at posttreatment, including substance use and associated problems, some trauma-related symptoms, cognitions related to SUD and PTSD, and several areas of pathology not targeted in the treatment (e.g., anorexia, somatization). Effect sizes were generally in the moderate to high range. Some gains were sustained at follow-up. SS appears a promising treatment for this population, but needs further study and perhaps additional clinical modification.
Literatur
1.
Zurück zum Zitat Giaconia RM, Reinherz HZ, Paradis AD, et al. Comorbidity of substance use disorders and posttraumatic stress disorder in adolescents. In: Ouimette P, Brown PJ, eds. Trauma and Substance Abuse: Causes, Consequences, and Treatment of Comorbid Disorders. Washington, DC: American Psychological Association Press; 2002:209–226. Giaconia RM, Reinherz HZ, Paradis AD, et al. Comorbidity of substance use disorders and posttraumatic stress disorder in adolescents. In: Ouimette P, Brown PJ, eds. Trauma and Substance Abuse: Causes, Consequences, and Treatment of Comorbid Disorders. Washington, DC: American Psychological Association Press; 2002:209–226.
2.
Zurück zum Zitat Kessler RC, Sonnega A, Bromet E, et al. Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry. 1995;52:1048–1060.PubMed Kessler RC, Sonnega A, Bromet E, et al. Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry. 1995;52:1048–1060.PubMed
3.
Zurück zum Zitat Najavits LM. A Woman's Addiction Workbook. Oakland, CA: New Harbinger; 2002. Najavits LM. A Woman's Addiction Workbook. Oakland, CA: New Harbinger; 2002.
4.
Zurück zum Zitat Ouimette P, Brown PJ. Trauma and Substance Abuse: Causes, Consequences, and Treatment of Comorbid Disorders. Washington, DC: American Psychological Association Press; 2002. Ouimette P, Brown PJ. Trauma and Substance Abuse: Causes, Consequences, and Treatment of Comorbid Disorders. Washington, DC: American Psychological Association Press; 2002.
5.
Zurück zum Zitat Najavits LM, Weiss RD, Shaw SR, et al. “Seeking Safety”: outcome of a new cognitive-behavioral psychotherapy for women with posttraumatic stress disorder and substance dependence. Journal of Traumatic Stress. 1998;11:437–456.PubMedCrossRef Najavits LM, Weiss RD, Shaw SR, et al. “Seeking Safety”: outcome of a new cognitive-behavioral psychotherapy for women with posttraumatic stress disorder and substance dependence. Journal of Traumatic Stress. 1998;11:437–456.PubMedCrossRef
6.
Zurück zum Zitat Brady KT, Dansky BS, Back SE, et al. Exposure therapy in the treatment of PTSD among cocaine-dependent individuals: preliminary findings. Journal of Substance Abuse Treatment. 2001;21:47–54.PubMedCrossRef Brady KT, Dansky BS, Back SE, et al. Exposure therapy in the treatment of PTSD among cocaine-dependent individuals: preliminary findings. Journal of Substance Abuse Treatment. 2001;21:47–54.PubMedCrossRef
7.
Zurück zum Zitat Najavits LM. Seeking Safety: A Treatment Manual for PTSD and Substance Abuse. New York, NY: Guilford Press; 2002. Najavits LM. Seeking Safety: A Treatment Manual for PTSD and Substance Abuse. New York, NY: Guilford Press; 2002.
8.
Zurück zum Zitat Zlotnick C, Najavits LM, Rohsenow DJ. A cognitive-behavioral treatment for incarcerated women with substance use disorder and posttraumatic stress disorder: findings from a pilot study. Journal of Substance Abuse Treatment. 2003;25:99–105.PubMedCrossRef Zlotnick C, Najavits LM, Rohsenow DJ. A cognitive-behavioral treatment for incarcerated women with substance use disorder and posttraumatic stress disorder: findings from a pilot study. Journal of Substance Abuse Treatment. 2003;25:99–105.PubMedCrossRef
9.
Zurück zum Zitat Hien DA, Cohen LR, Miele GM, et al. Promising treatments for women with comorbid PTSD and substance use disorders. American Journal of Psychiatry. 2004;161:1426–1432.PubMedCrossRef Hien DA, Cohen LR, Miele GM, et al. Promising treatments for women with comorbid PTSD and substance use disorders. American Journal of Psychiatry. 2004;161:1426–1432.PubMedCrossRef
10.
Zurück zum Zitat Najavits LM, Schmitz M, Gotthardt S, et al. Seeking Safety plus Exposure Therapy: an outcome study on dual diagnosis men. Journal of Psychoactive Drugs. 2005;37:425–435.PubMed Najavits LM, Schmitz M, Gotthardt S, et al. Seeking Safety plus Exposure Therapy: an outcome study on dual diagnosis men. Journal of Psychoactive Drugs. 2005;37:425–435.PubMed
11.
Zurück zum Zitat Holdcraft LC, Comtois KA. Description of and preliminary data from a women's dual diagnosis community mental health program. Canadian Journal of Community Mental Health. 2002;21:91–109. Holdcraft LC, Comtois KA. Description of and preliminary data from a women's dual diagnosis community mental health program. Canadian Journal of Community Mental Health. 2002;21:91–109.
12.
Zurück zum Zitat Burchfield B, Finn K, Marcinko L. Seeking Safety: Cognitive–Behavioral Group Therapy For Women With Posttraumatic Stress Disorder—An Evaluation Of Therapy Satisfaction And Decrease In Anxiety Symptomatology. Poster presented at the annual meeting of the Association for the Advancement of Behavior Therapy, Reno, NV; November, 2002. Burchfield B, Finn K, Marcinko L. Seeking Safety: Cognitive–Behavioral Group Therapy For Women With Posttraumatic Stress Disorder—An Evaluation Of Therapy Satisfaction And Decrease In Anxiety Symptomatology. Poster presented at the annual meeting of the Association for the Advancement of Behavior Therapy, Reno, NV; November, 2002.
13.
Zurück zum Zitat Cook JM, Walser RD, Kane V, et al. Dissemination and feasibility of a cognitive–behavioral treatment for substance use disorders and posttraumatic stress disorder in the Veterans Administration. Journal of Psychoactive Drugs., in press. Cook JM, Walser RD, Kane V, et al. Dissemination and feasibility of a cognitive–behavioral treatment for substance use disorders and posttraumatic stress disorder in the Veterans Administration. Journal of Psychoactive Drugs., in press.
14.
Zurück zum Zitat Najavits LM. Seeking Safety: a new psychotherapy for posttraumatic stress disorder and substance use disorder. In: Ouimette P, Brown PJ, eds. Trauma and Substance Abuse: Causes, Consequences, and Treatment of Comorbid Disorders. Washington, DC: American Psychological Association Press; 2002:147–170. Najavits LM. Seeking Safety: a new psychotherapy for posttraumatic stress disorder and substance use disorder. In: Ouimette P, Brown PJ, eds. Trauma and Substance Abuse: Causes, Consequences, and Treatment of Comorbid Disorders. Washington, DC: American Psychological Association Press; 2002:147–170.
15.
Zurück zum Zitat Seeking Safety Video Training Series. Brookline, MA: Treatment Innovations; 2005. Seeking Safety Video Training Series. Brookline, MA: Treatment Innovations; 2005.
16.
Zurück zum Zitat Weiss RD, Najavits LM, Greenfield SF, et al. Reliability of substance use self-reports in dually diagnosed outpatients. American Journal of Psychiatry. 1998;155:127–128.PubMed Weiss RD, Najavits LM, Greenfield SF, et al. Reliability of substance use self-reports in dually diagnosed outpatients. American Journal of Psychiatry. 1998;155:127–128.PubMed
17.
Zurück zum Zitat Nader KO, Newman E, Weathers FW, et al. Clinician-Administered PTSD Scale for Children and Adolescents for DSM-IV: National Center for PTSD (Boston, MA) and UCLA Trauma Psychiatry Program (Los Angeles, CA); 1998. Nader KO, Newman E, Weathers FW, et al. Clinician-Administered PTSD Scale for Children and Adolescents for DSM-IV: National Center for PTSD (Boston, MA) and UCLA Trauma Psychiatry Program (Los Angeles, CA); 1998.
18.
Zurück zum Zitat Winters KC, Henly GA. Adolescent Diagnostic Interview Test and Manual. Los Angeles: Western Psychological Services; 1993. Winters KC, Henly GA. Adolescent Diagnostic Interview Test and Manual. Los Angeles: Western Psychological Services; 1993.
19.
Zurück zum Zitat Sheehan D, Lecrubier Y, Harnett Sheehan K, et al. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry. 1998;59:22–33.PubMed Sheehan D, Lecrubier Y, Harnett Sheehan K, et al. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry. 1998;59:22–33.PubMed
20.
Zurück zum Zitat Najavits LM. Time Line. Unpublished measure. Harvard Medical School/McLean Hospital, Boston, MA; 1994. Najavits LM. Time Line. Unpublished measure. Harvard Medical School/McLean Hospital, Boston, MA; 1994.
21.
Zurück zum Zitat Green B. Trauma history questionnaire. In: Stamm BH, ed. Measurement of Stress, Trauma, and Adaptation. Lutherville, MD: Sidran Press; 1996:366–369. Green B. Trauma history questionnaire. In: Stamm BH, ed. Measurement of Stress, Trauma, and Adaptation. Lutherville, MD: Sidran Press; 1996:366–369.
22.
Zurück zum Zitat Kaminer Y, Blitz C, Burleson JA, Sussman J. The Teen Treatment Services Review (T-TSR). Journal of Substance Abuse Treatment. 1998;15:291–300.PubMedCrossRef Kaminer Y, Blitz C, Burleson JA, Sussman J. The Teen Treatment Services Review (T-TSR). Journal of Substance Abuse Treatment. 1998;15:291–300.PubMedCrossRef
23.
Zurück zum Zitat Winters KC, Henly GA. Personal Experience Inventory Test and Manual. Los Angeles: Western Psychological Services; 1989. Winters KC, Henly GA. Personal Experience Inventory Test and Manual. Los Angeles: Western Psychological Services; 1989.
24.
Zurück zum Zitat Wright FD. Beliefs about substance use. Philadelphia, PA: Unpublished scale, Center for Cognitive Therapy, University of Pennsylvania; 1992. Wright FD. Beliefs about substance use. Philadelphia, PA: Unpublished scale, Center for Cognitive Therapy, University of Pennsylvania; 1992.
25.
Zurück zum Zitat Jaffe AJ, Kilbey MM. The Cocaine Expectancy Questionnaire (CEQ): construction and predictive validity. Psychological Assessment. 1994;6:18–26.CrossRef Jaffe AJ, Kilbey MM. The Cocaine Expectancy Questionnaire (CEQ): construction and predictive validity. Psychological Assessment. 1994;6:18–26.CrossRef
26.
Zurück zum Zitat Janoff Bulman R. World Assumptions Scale. Unpublished measure: University of Massachusetts at Amherst; 1989. Janoff Bulman R. World Assumptions Scale. Unpublished measure: University of Massachusetts at Amherst; 1989.
27.
Zurück zum Zitat Reynolds WM. Adolescent Psychopathology Scale Test and Manual. Odessa, FL: Psychological Assessment Resources; 1998. Reynolds WM. Adolescent Psychopathology Scale Test and Manual. Odessa, FL: Psychological Assessment Resources; 1998.
28.
Zurück zum Zitat Briere J. Trauma Symptom Checklist for Children Test and Manual. Odessa, FL: Psychological Assessment Resources; 1996. Briere J. Trauma Symptom Checklist for Children Test and Manual. Odessa, FL: Psychological Assessment Resources; 1996.
29.
Zurück zum Zitat Attkisson CC, Zwick R. The Client Satisfaction Questionnaire: psychometric properties and correlations with service utilization and psychotherapy outcome. Evaluation and Program Planning. 1982;5:233–237.PubMedCrossRef Attkisson CC, Zwick R. The Client Satisfaction Questionnaire: psychometric properties and correlations with service utilization and psychotherapy outcome. Evaluation and Program Planning. 1982;5:233–237.PubMedCrossRef
30.
Zurück zum Zitat Luborsky L, Crits-Cristoph P, Margolis L, et al. Two helping alliance methods for predicting outcomes of psychotherapy: a counting signs versus a global rating method. Journal of Nervous and Mental Disease. 1983;171:480–492.PubMedCrossRef Luborsky L, Crits-Cristoph P, Margolis L, et al. Two helping alliance methods for predicting outcomes of psychotherapy: a counting signs versus a global rating method. Journal of Nervous and Mental Disease. 1983;171:480–492.PubMedCrossRef
31.
Zurück zum Zitat Najavits LM, Liese BS. Seeking Safety Adherence Scale (revised). Unpublished measure. Harvard Medical School/McLean Hospital, Boston, MA; 2000. Najavits LM, Liese BS. Seeking Safety Adherence Scale (revised). Unpublished measure. Harvard Medical School/McLean Hospital, Boston, MA; 2000.
32.
Zurück zum Zitat Hansen NB. The psychotherapy dose-response effect and its implications for treatment delivery services. Clinical Psychology: Science and Practice. 2002;9:329–343.CrossRef Hansen NB. The psychotherapy dose-response effect and its implications for treatment delivery services. Clinical Psychology: Science and Practice. 2002;9:329–343.CrossRef
33.
Zurück zum Zitat Project MATCH Research Group. Matching alcoholism treatments to client heterogeneity: project MATCH posttreatment drinking outcomes. Journal of Studies on Alcohol. 1997;58:7–29. Project MATCH Research Group. Matching alcoholism treatments to client heterogeneity: project MATCH posttreatment drinking outcomes. Journal of Studies on Alcohol. 1997;58:7–29.
34.
Zurück zum Zitat Cohen J. Statistical Power Analysis for the Behavioral Sciences, 2nd ed. Hillsdale, NJ: Lawrence Earlbaum Associates; 1988. Cohen J. Statistical Power Analysis for the Behavioral Sciences, 2nd ed. Hillsdale, NJ: Lawrence Earlbaum Associates; 1988.
35.
Zurück zum Zitat Davidson JRT. Recognition and treatment of posttraumatic stress disorder. Journal of the American Medical Association. 2001;286:584–588.PubMedCrossRef Davidson JRT. Recognition and treatment of posttraumatic stress disorder. Journal of the American Medical Association. 2001;286:584–588.PubMedCrossRef
36.
Zurück zum Zitat Dansky BS, Roitzsch JC, Brady KT, et al. Posttraumatic stress disorder and substance abuse: use of research in a clinical setting. Journal of Traumatic Stress. 1997;10:141–148.PubMedCrossRef Dansky BS, Roitzsch JC, Brady KT, et al. Posttraumatic stress disorder and substance abuse: use of research in a clinical setting. Journal of Traumatic Stress. 1997;10:141–148.PubMedCrossRef
37.
Zurück zum Zitat Najavits LM, Weiss RD, Shaw SR. The link between substance abuse and posttraumatic stress disorder in women: a research review. American Journal on Addictions. 1997;6:273–283.PubMedCrossRef Najavits LM, Weiss RD, Shaw SR. The link between substance abuse and posttraumatic stress disorder in women: a research review. American Journal on Addictions. 1997;6:273–283.PubMedCrossRef
38.
Zurück zum Zitat Weller LA. Group therapy to treat substance use and traumatic symptoms in female veterans. Federal Practitioner. April 2005;22:27–38. Weller LA. Group therapy to treat substance use and traumatic symptoms in female veterans. Federal Practitioner. April 2005;22:27–38.
39.
Zurück zum Zitat Coffey SF, Dansky BS, Brady KT. Exposure-based, trauma-focused therapy for comorbid posttraumatic stress disorder-substance use disorder. In: Ouimette P, Brown PJ, eds. Trauma and Substance Abuse: Causes, Consequences, and Treatment of Comorbid Disorders. Washington, DC: American Psychological Association Press; 2002:209–226. Coffey SF, Dansky BS, Brady KT. Exposure-based, trauma-focused therapy for comorbid posttraumatic stress disorder-substance use disorder. In: Ouimette P, Brown PJ, eds. Trauma and Substance Abuse: Causes, Consequences, and Treatment of Comorbid Disorders. Washington, DC: American Psychological Association Press; 2002:209–226.
Metadaten
Titel
Seeking Safety Therapy for Adolescent Girls with PTSD and Substance Use Disorder: A Randomized Controlled Trial
verfasst von
Lisa M. Najavits, PhD
Robert J. Gallop, PhD
Roger D. Weiss, MD
Publikationsdatum
01.10.2006
Erschienen in
The Journal of Behavioral Health Services & Research / Ausgabe 4/2006
Print ISSN: 1094-3412
Elektronische ISSN: 2168-6793
DOI
https://doi.org/10.1007/s11414-006-9034-2

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