Treatment of Incarcerated Women With Substance Abuse and Posttraumatic Stress Disorder, Final Report

• NCJ Number: 195165
• Author(s): Caron Zlotnick Ph.D.
• Date Published: 2002
• Length: 29 pages
• Grant Number(s): 99-WT-VX-0004
• Agencies: NIJ-Sponsored
• Publication Type: Program/Project Evaluation

Annotation

The overall goal of this study was to evaluate the initial efficacy, feasibility, and acceptability of "Seeking Safety" (SS) treatment in a sample of incarcerated women with morbid posttraumatic stress disorder (PTSD) and substance use disorder (SUD).

Abstract

More specifically, the study conducted an open feasibility trial of SS treatment in a sample of six incarcerated women with SUD and PTSD and performed a randomized controlled pilot study to evaluate the initial efficacy, feasibility, and acceptability of the proposed treatment as an adjunct to treatment as usual (TAU) The researchers compared this experimental group to a TAU control group in a sample of 22 incarcerated women with comorbid PTSD and SUD. Seeking Safety is a cognitive-behavioral psychotherapy treatment that is based on an integration of the literature on SUD and PTSD. All participants were drawn from the substance abuse treatment program in the minimum-security arm of Women's Facility of the Adult Correctional Institution in Rhode Island. Assessments were conducted at pretreatment, posttreatment, and 6 weeks and 12 weeks postrelease intervals. The Addiction Severity Index was used to assess change in the severity of substance abuse in the past 3 days, and the Clinician Administered Posttraumatic Stress Disorder Scale provided a diagnosis of PTSD as well as an assessment of the degree of PTSD symptoms. To assess lifetime history of trauma, the Trauma History Questionnaire was administered at pretreatment. Patient satisfaction with treatment and therapists' assessments were also determined. In the open trial of women who received SS treatment as an adjunct to TAU, there were significant improvements in PTSD symptoms from pretreatment to posttreatment, and this was maintained through 3 months after release. At 6 weeks postrelease, there were significant decreases in severity of substance use and degree of legal problems. Only 35 percent of the women had used an illegal substance within 3 months after release. The study found no differences between the group that received SS treatment as an adjunct to TAU and the TAU group on any of the indexes of interest. One explanation is that the small sample size in the control group made it difficult to detect differences between the treatment and the control groups. An expansion of SS treatment to the postrelease period may substantially improve the long-term impact of the prison-based treatment. 4 tables