title: Seeking Safety treatment for male veterans with a substance use disorder and post-traumatic stress disorder symptomatology.
abstract: OBJECTIVE
  To determine whether substituting Seeking Safety (SS), a manualized therapy for comorbid substance use disorders (SUD) and post-traumatic stress disorder (PTSD) for part of treatment-as-usual (TAU) improves substance use outcomes.
  
  
  METHODS
  Randomized controlled effectiveness trial.
  
  
  METHODS
  Out-patient Veterans Administration Health Care System SUD clinic.
  
  
  METHODS
  Ninety-eight male military Veterans with a SUD and co-occurring PTSD symptomatology.
  
  
  METHODS
  Drug and alcohol use and PTSD severity, measured on the first day of treatment, and 3 (i.e. the planned end of SS sessions) and 6 months following the baseline assessment. Treatment attendance and patient satisfaction were measured following treatment (3-month follow-up). Active coping was measured at treatment intake and following treatment.
  
  
  RESULTS
  SS compared to TAU was associated with better drug use outcomes (P < 0.05), but alcohol use and PTSD severity decreased equally under both treatments (P's < 0.01). SS versus TAU was associated with increased treatment attendance, client satisfaction and active coping (all P's < 0.01). However, neither these factors nor decreases in PTSD severity mediated the effect of treatment on drug use.
  
  
  CONCLUSIONS
  The manualized treatment approach for substance use disorder, Seeking Safety, is well received and associated with better drug use outcomes than 'treatment as usual' in male veterans with post-traumatic stress disorder. However, the mechanism of its effect is unclear.
authors.affiliation: Center for Health Care Evaluation, Veterans Affairs Palo Alto Health Care System, Menlo Park, CA 94025, USA. matthew.t.boden@gmail.com
authors.forename: Matthew Tyler
authors.initials: MT
authors.lastname: Boden
authors.forename: Rachel
authors.initials: R
authors.lastname: Kimerling
authors.forename: Jason
authors.initials: J
authors.lastname: Jacobs-Lentz
authors.forename: Dan
authors.initials: D
authors.lastname: Bowman
authors.forename: Christopher
authors.initials: C
authors.lastname: Weaver
authors.forename: Diane
authors.initials: D
authors.lastname: Carney
authors.forename: Robyn
authors.initials: R
authors.lastname: Walser
authors.forename: Jodie A
authors.initials: JA
authors.lastname: Trafton
mesh_terms: D000223:Adaptation, Psychological; D000553:Ambulatory Care; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D017831:Diagnosis, Dual (Psychiatry); D006801:Humans; D008297:Male; D008875:Middle Aged; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology / Q000534:rehabilitation*; D019966:Substance-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D016896:Treatment Outcome; D014728:Veterans