title: Outcomes for women with co-occurring disorders and trauma: program and person-level effects.
abstract: Six-month outcomes are evaluated from a 9-site quasi-experimental study of women with mental health and substance use disorders who have experienced physical or sexual abuse who enrolled in either comprehensive, integrated, trauma-informed, and consumer/survivor/recovering person-involved services (N = 1023) or usual care (N = 983). Mental health, post-traumatic stress symptoms, and substance use outcomes are assessed with multilevel regression models, controlling for program and personal characteristics. Person-level variables predict outcomes independent of intervention condition and, to a small extent, moderate intervention and program effects. In sites where the intervention condition provided more integrated counseling than the comparison condition, there are increased effects on mental health and substance use outcomes; these effects are partially mediated by person-level variables. These results encourage further research to identify the longer-term effects of integrated counseling for women with co-occurring disorders and trauma histories.
authors.affiliation: Department of Health Policy and Administration, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. joe_morrissey@unc.edu
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Morrissey
authors.forename: Alan R
authors.initials: AR
authors.lastname: Ellis
authors.forename: Margaret
authors.initials: M
authors.lastname: Gatz
authors.forename: Hortensia
authors.initials: H
authors.lastname: Amaro
authors.forename: Beth Glover
authors.initials: BG
authors.lastname: Reed
authors.forename: Andrea
authors.initials: A
authors.lastname: Savage
authors.forename: Norma
authors.initials: N
authors.lastname: Finkelstein
authors.forename: Ruta
authors.initials: R
authors.lastname: Mazelis
authors.forename: Vivian
authors.initials: V
authors.lastname: Brown
authors.forename: Elizabeth W
authors.initials: EW
authors.lastname: Jackson
authors.forename: Steven
authors.initials: S
authors.lastname: Banks
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology / Q000534:rehabilitation*; D015897:Comorbidity; D003376:Counseling / Q000706:statistics & numerical data; D019033:Delivery of Health Care, Integrated / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008016:Life Change Events; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data; D015397:Program Evaluation / Q000706:statistics & numerical data; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000534:rehabilitation*; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation*; D014481:United States; D014754:Violence / Q000517:prevention & control / Q000706:statistics & numerical data*; D014932:Women's Health Services / Q000706:statistics & numerical data*