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Seeking Safety treatment for male veterans with a substance use disorder and post-traumatic stress disorder symptomatology

Authors

  • Matthew Tyler Boden,

    Corresponding author
    1. Center for Health Care Evaluation, Veterans Affairs Palo Alto Health Care System, Menlo Park, CA
    2. National Center for Posttraumatic Stress Disorder, Veterans Affairs Palo Alto Health Care System, Menlo Park, CA, USA CA, USA
      Matthew Tyler Boden, Center for Health Care Evaluation, VA Palo Alto Health Care System, Menlo Park Division (152), 795 Willow Road, Menlo Park, CA 94025, USA. E-mail: matthew.t.boden@gmail.com
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  • Rachel Kimerling,

    1. National Center for Posttraumatic Stress Disorder, Veterans Affairs Palo Alto Health Care System, Menlo Park, CA, USA CA, USA
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  • Jason Jacobs-Lentz,

    1. Center for Health Care Evaluation, Veterans Affairs Palo Alto Health Care System, Menlo Park, CA
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  • Dan Bowman,

    1. Center for Health Care Evaluation, Veterans Affairs Palo Alto Health Care System, Menlo Park, CA
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  • Christopher Weaver,

    1. Center for Health Care Evaluation, Veterans Affairs Palo Alto Health Care System, Menlo Park, CA
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    • Christopher Weaver is currently at Palo Alto University.

  • Diane Carney,

    1. Center for Health Care Evaluation, Veterans Affairs Palo Alto Health Care System, Menlo Park, CA
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  • Robyn Walser,

    1. National Center for Posttraumatic Stress Disorder, Veterans Affairs Palo Alto Health Care System, Menlo Park, CA, USA CA, USA
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  • Jodie A. Trafton

    1. Center for Health Care Evaluation, Veterans Affairs Palo Alto Health Care System, Menlo Park, CA
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Matthew Tyler Boden, Center for Health Care Evaluation, VA Palo Alto Health Care System, Menlo Park Division (152), 795 Willow Road, Menlo Park, CA 94025, USA. E-mail: matthew.t.boden@gmail.com

ABSTRACT

Aims  To determine whether substituting Seeking Safety (SS), a manualized therapy for comorbid substance use disorders (SUD) and post-traumatic stress disorder (PTSD) for part of treatment-as-usual (TAU) improves substance use outcomes.

Design  Randomized controlled effectiveness trial.

Settings  Out-patient Veterans Administration Health Care System SUD clinic.

Participants  Ninety-eight male military Veterans with a SUD and co-occurring PTSD symptomatology.

Measurements  Drug and alcohol use and PTSD severity, measured on the first day of treatment, and 3 (i.e. the planned end of SS sessions) and 6 months following the baseline assessment. Treatment attendance and patient satisfaction were measured following treatment (3-month follow-up). Active coping was measured at treatment intake and following treatment.

Findings  SS compared to TAU was associated with better drug use outcomes (P < 0.05), but alcohol use and PTSD severity decreased equally under both treatments (P's < 0.01). SS versus TAU was associated with increased treatment attendance, client satisfaction and active coping (all P's < 0.01). However, neither these factors nor decreases in PTSD severity mediated the effect of treatment on drug use.

Conclusions  The manualized treatment approach for substance use disorder, Seeking Safety, is well received and associated with better drug use outcomes than ‘treatment as usual’ in male veterans with post-traumatic stress disorder. However, the mechanism of its effect is unclear.

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