“Transcend”: Initial outcomes from a posttraumatic stress disorder/substance abuse treatment program

Donovan, Beverly; Padin-Rivera, Edgardo; Kowaliw, Sean

doi:10.1023/a:1013094206154

Cited by 110 publications

(96 citation statements)

References 44 publications

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“…Extensive clinical experience is congruent with research evidence regarding the severity and chronicity of war-related PTSD symptoms despite considerable and expensive treatment efforts Archibald & Tuddenham, 1965;Kulka et al, 1990). At the same time, an extremely important finding replicated in other studies (Hyer, Scurfield, Boyd, Smith, & Burke, 1996;Donovan, Padin-Rivera, & Kowaliw, 2001) reported on the improvement of outcome factors at the time of discharge from the inpatient treatment programs SIPU (and EBTPU and general psychiatry). The similar result obtained in the NEPEC study was considered to be of little significance.…”

Section: Critique Of Nepec Findings Interpretations and Policy Implsupporting

confidence: 61%

Ask Not For Whom The Bell Tolls

Scurfield

Wilson

2003

Trauma, Violence, & Abuse

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This article reviews and analyzes two national studies of the efficacy of treatment for war veterans suffering from post-traumatic stress disorder (PTSD). A careful analysis of the studies conducted by the Department of Veterans Affairs (DVA) Northeast Program Evaluation Center (NEPEC) reveals conceptual, methodological, and design flaws in the research, which reports minimal treatment efficacy for PTSD. Based on this limited, if not biased, data, the results were used for policy purposes to dismantle inpatient PTSD hospital units and trauma-focus treatments. A critique is offered as a review to suggest how future studies might be conducted, designed, and evaluated, including the need for independent, "outside" peer reviews inasmuch as the issue of treatment outcomes generalizes to many nonmilitary populations.Key words : PTSD, research, treatment, policy, therapy, outcome, DVA, Vietnam veterans AS THE FIELD OF POST-TRAUMATIC Stress Disorder (PTSD) has grown since it was classified in 1980 as an anxiety disorder (APA, 1980), there has been a corresponding interest in understanding the effectiveness of clinical interventions . As noted in comprehensive analyses of the growth of PTSD as a field (Friedman, 2000; Van der Kolk, McFarlane, & Weisaeth, 1996; Wilson & Raphael, 1993), the scientific research on Vietnam veterans spearheaded a plethora of empirical investigations of the disorder and its treatment due to the large prevalence of PTSD among the 3.1 million personnel who served in Southeast Asia during the Vietnam War (Kulka et al., 1990). In that sense, the Department of Veteran Affairs (DVA) intensive inpatient, outpatient, and outreach counseling programs for war veterans have initiated a wide range of approaches for treating chronic 112 AUTHORS' NOTE: We wish to acknowledge the assistance of Dr. Thomas A. Moran. The authors are solely responsible for all subjective, personal, and concluding perspectives expressed. We do want to acknowledge the very helpful factual information received that was incorporated into an early draft of this article from the following colleagues: Kathleen D. Letizio, Larry Wohlberg, Ph.D., Denver VAMC; Leslie Root, Ph.D., Biloxi VAMC, Gulfport Division; and Beverly Donovan, Ph.D., Brecksville VAMC. This article is based partly on a presentation, "PTSD: Controversy in Outcome," at the PTSD Treatment Outcome Symposium, Hines VA Medical Center, Chicago, IL, on September 15, 1998 PTSD. Only recently, however, have these efforts undergone evaluation to determine their effectiveness as assessed by a range of outcome criteria for the improvement of symptoms that impair adaptation and functioning. Thus, the review and analysis of treatment outcome studies is very important because it sheds light and offers insight as to the core issues involved in understanding the efficacy of treatment approaches. As stated by , "what treatments work best for which kind of PTSD client and under what circumstances" (p. 15). Moreover, the extensiveness of research on treatment outcomes conducted by the...

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Section: Critique Of Nepec Findings Interpretations and Policy Implsupporting

confidence: 61%

Ask Not For Whom The Bell Tolls

Scurfield

Wilson

2003

Trauma, Violence, & Abuse

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“…The ARTS program teaches self-regulatory and relapse prevention skills prior to doing traumatic memory exposure work. Transcend (Donovan, Padin-Rivera, & Kowaliw, 2001) is a 12-week group therapy that conducts PTSD education, self-management skill training, cognitive restructuring, and one session of trauma memory recall. Transcend demonstrated clinically significant reductions in PTSD and substance use that were sustained at 6-and 12-month follow-ups with military veterans.…”

Section: Skills Training In Affect and Interpersonal Regulation With mentioning

confidence: 99%

Treatment of complex posttraumatic self-dysregulation

Ford

Courtois

Steele³

et al. 2005

J. Traum. Stress

205

148

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The authors describe a three-phase sequential integrative model for the psychotherapy of complex posttraumatic self-dysregulation: Phase 1 (alliance formation and stabilization), Phase 2 (trauma processing), and Phase 3 (functional reintegration). The technical precautions designed to maximize safety, trauma processing, and reintegration regardless of the specific treatment approach are discussed. Existing and emerging treatment models that address posttraumatic dysregulation of consciousness, bodily functioning, emotion, and interpersonal attachments are also described. The authors conclude with suggestions for further clinical innovation and research evaluation of therapeutic models that can enhance the treatment of PTSD by addressing complex posttraumatic self-dysregulation.

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“…A variety of promising cognitive-behavioral interventions for those dually diagnosed with PTSD and SUD are emerging, including Seeking Safety (Najavits, 2004;Zlotnick, Najavits, Rohsenow, & Johnson, 2003), Substance Dependence PTSD Therapy (Triffleman, Carroll, & Kellogg, 1999), and "Transcend" (Donovan, Padin-Rivera, & Kowaliw, 2001). These interventions generally emphasize learning how to identify and cope with relapse triggers.…”

mentioning

confidence: 99%

PTSD symptoms, substance use, and vipassana meditation among incarcerated individuals

Simpson

Kaysen

Bowen

et al. 2007

Journal of Traumatic Stress

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The present study evaluated whether Posttraumatic Stress Disorder (PTSD) symptom severity was associated with participation and treatment outcomes comparing a Vipassana meditation course to treatment as usual in an incarcerated sample. This study utilizes secondary data. The original study demonstrated that Vipassana meditation is associated with reductions in substance use. The present study found that PTSD symptom severity did not differ significantly between those who did and did not volunteer to take the course. Participation in the Vipassana course was associated with significantly greater reductions in substance use than treatment as usual, regardless of PTSD symptom severity levels. These results suggest that Vipassana meditation is worthy of further study for those with comorbid PTSD and substance use problems.

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“Transcend”: Initial outcomes from a posttraumatic stress disorder/substance abuse treatment program

Cited by 110 publications

References 44 publications

Ask Not For Whom The Bell Tolls

Ask Not For Whom The Bell Tolls

Treatment of complex posttraumatic self-dysregulation

PTSD symptoms, substance use, and vipassana meditation among incarcerated individuals

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