A Pilot Study of Seeking Safety in a Sample of German Women Outpatients with Substance Dependence and Posttraumatic Stress Disorder

Abstract

Seeking Safety is an integrated coping skills therapy for substance use disorder (SUD) and posttraumatic stress disorder (PTSD). Our aim was to examine the effects of Seeking Safety in a sample of female German outpatients with current SUD and PTSD. A total of 53 women were offered 12 weekly sessions of Seeking Safety, conducted in group modality. Women (N=33) who attended at least six sessions were considered minimum-dose completers and were in the analysis. We measured PTSD and substance use symptoms using the Posttraumatic Diagnostic Scale (PDS) and the Addiction Severity Index (ASI-Lite) at end-of-treatment and three-month follow-up. Additional measures were the Brief Symptom Checklist (BSI) and the Inventory of Interpersonal Problems (IIP-25). Our sample reported chronic SUD, multiple prior detoxifications, and serious childhood trauma. We found medium to large effect sizes for improvements in PTSD symptoms, general psychopathology, and interpersonal problems at end-of-treatment, all of which were sustained at follow-up. Alcohol use improved significantly only at follow-up. This study suggests that the model was associated with positive effects, at least in a subgroup of women attending a minimum of sessions. Limitations include the lack of a control condition as well as an intention-to-treat analysis.

A multisite randomized controlled trial of Seeking Safety vs. Relapse Prevention Training for women with co-occurring posttraumatic stress disorder and substance use disorders

“…Given the differences between health care systems and cultures, there is a need to evaluate the existing programmes in the respective countries (Magruder, McLaughlin, & Elmore Borbon, 2017). Two studies of Seeking Safety in Germany showed a good acceptance of the programme by the participants (Schäfer et al, 2010) and at least medium sized effects on PTSD symptoms, general psychopathology, interpersonal problems and alcohol use (Kaiser et al, 2015). However, both were uncontrolled studies and RCTs on Seeking Safety in Europe do not exist so far.…”

Understanding the role of childhood abuse and neglect as a cause and consequence of substance abuse: the German CANSAS network

“…The literature indicates, overall, positive outcomes on SUD and PTSD symptoms, as well as other consequences of CAN, in various populations (Najavits & Hien, 2013). A pilot study in Germany yielded positive results (Kaiser et al, 2015), suggesting that the programme could be a promising option also for European SUD settings, but no controlled studies on the efficacy of this treatment have been published in Europe so far.…”