Version Date: Nov 4, 2005 View help for published
Principal Investigator(s): View help for Principal Investigator(s)
Caron Zlotnick, Brown University. Department of Psychiatry and Human Behavior
https://doi.org/10.3886/ICPSR03416.v1
Version V1
The 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 comorbid substance use disorder (SUD) and comorbid post-traumatic stress disorder (PTSD). Seeking Safety, a cognitive-behavioral psychotherapy treatment, is a psychosocial treatment for women with comorbid PTSD and SUD and, at the time this study was conducted, it was the treatment with the most efficacy data for this population. SS treatment appears to be a promising intervention for incarcerated women with PTSD and SUD because (1) the treatment targets many of the deficits found in this population that may interfere with their recovery and place these women at risk for reoffending (such as impulsiveness, anger dyscontrol, and maladaptive lifestyle activities), and (2) it teaches skills to manage these problematic behaviors. This study aimed to conduct an open feasibility trial of Seeking Safety treatment in a sample of six incarcerated women with SUD and PTSD and to conduct 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), compared to a TAU control group in a sample of 22 incarcerated women with comorbid PTSD and SUD. The primary hypothesis was that, compared to the TAU condition, women in the SS treatment condition would have less severe drug and alcohol use as well as fewer PTSD symptoms and legal problems after intervention, and at six weeks and three months after release. The first six participants recruited for the study received SS group treatment as an adjunct to the treatment provided by the Discovery Program, the substance abuse treatment program in the minimum security arm of the Women's Facility of the Adult Correctional Institution in Providence, Rhode Island. The remaining participants were randomly assigned to either the control group (TAU) or to a group that received SS treatment as an adjunct to TAU. The treatment groups were conducted by clinicians who worked as substance abuse therapists in the Discovery Program and a clinical psychologist from Brown University. All SS therapists received training in delivering SS therapy from Dr. Lisa Najavits, who developed SS treatment. Assessments were conducted at pretreatment, post-treatment during incarceration, and three and six months postrelease for PTSD-related measures. Measures of severity of substance abuse and legal problems were taken at pretreatment, as well as at the six- and 12-week postrelease intervals. Measures were taken with a variety of clinical instruments, including the Addiction Severity Index (ASI), the Structured Clinical Interview for DSM-IV (SCID) module on substance use, the Clinician Administered Post-Traumatic Stress Disorder Scale-I (CAPS-I), the Trauma History Questionnaire (THQ), the Helping Alliance Questionnaire-II (HAQ-II), the Client Satisfaction Questionnaire, and the End-of-Treatment Questionnaire. Basic demographic data were also collected from administrative records. Variables include alcohol, drug, and legal composite scores at pretreatment and post-treatment, number of relapses, whether the woman returned to prison, whether the woman lied about substance abuse, use of particular substances one month prior to prison and during lifetime, PTSD indicators of frequency and intensity, total client satisfaction scores, patients' ratings of therapists and treatment, and trauma scales for crime, sexual abuse, and physical abuse. Demographic variables include age, ethnic background, education, first time in prison, the nature of the current conviction, and number of arrests with convictions.
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Additional information about the clinical scales used in this data collection can be found in the appendix of the codebook.
The 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 comorbid substance use disorder (SUD) and comorbid post-traumatic stress disorder (PTSD). Seeking Safety, a cognitive-behavioral psychotherapy treatment, is a psychosocial treatment for women with comorbid PTSD and SUD and, at the time this study was conducted, it was the treatment with the most efficacy data for this population. SS treatment appears to be a promising intervention for incarcerated women with PTSD and SUD because (1) the treatment targets many of the deficits found in this population that may interfere with their recovery and place these women at risk for reoffending (such as impulsiveness, anger dyscontrol, and maladaptive lifestyle activities), and (2) it teaches skills to manage these problematic behaviors. This study aimed to conduct an open feasibility trial of Seeking Safety treatment in a sample of six incarcerated women with SUD and PTSD and to conduct 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), compared to a TAU control group in a sample of 22 incarcerated women with comorbid PTSD and SUD. The primary hypothesis was that, compared to the TAU condition, women in the SS treatment condition would have less severe drug and alcohol use as well as fewer PTSD symptoms and legal problems after intervention, and at six weeks and three months after release.
The first six participants recruited for the study received SS group treatment as an adjunct to the treatment provided by the Discovery Program, the substance abuse treatment program in the minimum security arm of the Women's Facility of the Adult Correctional Institution in Providence, Rhode Island. The remaining participants were randomly assigned to either the control group (TAU) or to a group that received SS treatment as an adjunct to TAU. The treatment groups were conducted by clinicians who worked as substance abuse therapists in the Discovery Program and a clinical psychologist from Brown University. All SS therapists received training in delivering SS therapy from Dr. Lisa Najavits, who developed SS treatment. SS treatment focuses on developing a specific cognitive, behavioral, or interpersonal skill, with each skill designed to combat both SUD and PTSD simultaneously. The primary goals of the treatment are abstinence from substances and personal safety. Assessments were conducted at pretreatment, post-treatment during incarceration, and three and six months postrelease for PTSD-related measures. Measures of severity of substance abuse and legal problems were taken at pretreatment, as well as at the six- and 12-week postrelease intervals. Measures were taken with a variety of clinical instruments. The Addiction Severity Index (ASI) was used at intake to assess change in the severity of substance abuse in the past 30 days. The legal composite score from the ASI was used to assess change in criminal activities. The legal composite index contained information about arrests, incarcerations, and engagement in criminal activity since release from prison. At intake the women were assessed for legal problems in the 30 days prior to entering prison. The Structured Clinical Interview for the DSM-IV (SCID) module on substance use was used to provide a diagnosis of alcohol or drug use or dependence. The Clinician Administered Post-Traumatic Stress Disorder Scale-I (CAPS-I) 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 (THQ) was given at pretreatment. This measure yielded four frequency scores for physical, sexual, general disaster, and crime-related traumas. At post-treatment the participants' views of treatment were assessed on the Helping Alliance Questionnaire-II (HAQ-II) and the Client Satisfaction Questionnaire. At post-treatment the patients' perceptions of the helpfulness of components of SS treatment were assessed with the End-of-Treatment Questionnaire. Basic demographic data, such as age, education, and criminal history, were also collected from administrative records.
Not applicable.
Women inmates suffering from PTSD and SUD in Rhode Island.
Demographic data were collected from administrative records. Clinical data were obtained from the Addiction Severity Index, the Structured Clinical Interview for DSM-IV, the Clinician Administered Post-Traumatic Stress Disorder Scale-I, the Trauma History Questionnaire, the Helping Alliance Questionnaire-II, the Client Satisfaction Questionnaire, and the End-of-Treatment Questionnaire.
Variables include alcohol, drug, and legal composite scores at pretreatment and post-treatment, number of relapses, whether the woman returned to prison, whether the woman lied about substance abuse, use of particular substances one month prior to prison and during lifetime, PTSD indicators of frequency and intensity, total client satisfaction scores, patients' ratings of therapists and treatment, and trauma scales for crime, sexual abuse, and physical abuse. Demographic variables include age, ethnic background, education, first time in prison, the nature of the current conviction, and number of arrests with convictions.
Not applicable.
This data collection includes scales from the Addiction Severity Index (McLellan et al., 1992), Structured Clinical Interview for DSM-IV (First et al., 1996), Clinician Administered Post-Traumatic Stress Disorder Scale-I (Blake et al., 1990), Trauma History Questionnaire (Greene, 1995), Helping Alliance Questionnaire-II (Luborky et al., 1996), Client Satisfaction Questionnaire (Attkisson and Zwick, 1982), and the End-of-Treatment Questionnaire (Najavitis, 1994).
Hide2002-11-27
2005-11-04 On 2005-03-14 new files were added to one or more datasets. These files included additional setup files as well as one or more of the following: SAS program, SAS transport, SPSS portable, and Stata system files. The metadata record was revised 2005-11-04 to reflect these additions.
2002-11-27 ICPSR data undergo a confidentiality review and are altered when necessary to limit the risk of disclosure. ICPSR also routinely creates ready-to-go data files along with setups in the major statistical software formats as well as standard codebooks to accompany the data. In addition to these procedures, ICPSR performed the following processing steps for this data collection:
The public-use data files in this collection are available for access by the general public. Access does not require affiliation with an ICPSR member institution.
This dataset is maintained and distributed by the National Archive of Criminal Justice Data (NACJD), the criminal justice archive within ICPSR. NACJD is primarily sponsored by three agencies within the U.S. Department of Justice: the Bureau of Justice Statistics, the National Institute of Justice, and the Office of Juvenile Justice and Delinquency Prevention.
