title: Synergy between seeking safety and twelve-step affiliation on substance use outcomes for women.
abstract: OBJECTIVE
  The Recovery Management paradigm provides a conceptual framework for the examination of joint impact of a focal treatment and post-treatment service utilization on substance abuse treatment outcomes. We test this framework by examining the interactive effects of a treatment for comorbid PTSD and substance use, Seeking Safety, and post-treatment Twelve-Step Affiliation (TSA) on alcohol and cocaine use.
  
  
  METHODS
  Data from 353 women in a six-site, randomized controlled effectiveness trial within the NIDA Clinical Trials Network were analyzed under latent class pattern mixture modeling. LCPMM was used to model variation in Seeking Safety by TSA interaction effects on alcohol and cocaine use.
  
  
  RESULTS
  Significant reductions in alcohol use among women in Seeking Safety (compared to health education) were observed; women in the Seeking Safety condition who followed up with TSA had the greatest reductions over time in alcohol use. Reductions in cocaine use over time were also observed but did not differ between treatment conditions nor were there interactions with post-treatment TSA.
  
  
  CONCLUSIONS
  Findings advance understanding of the complexities for treatment and continuing recovery processes for women with PTSD and SUDs, and further support the chronic disease model of addiction.
authors.affiliation: Department of Psychology, L.L. Thurstone Psychometric Laboratory, UNC-Chapel Hill. amorganlopez@rti.org
authors.forename: Antonio A
authors.initials: AA
authors.lastname: Morgan-Lopez
authors.forename: Lissette M
authors.initials: LM
authors.lastname: Saavedra
authors.forename: Denise A
authors.initials: DA
authors.lastname: Hien
authors.forename: Aimee N
authors.initials: AN
authors.lastname: Campbell
authors.forename: Elwin
authors.initials: E
authors.lastname: Wu
authors.forename: Lesia
authors.initials: L
authors.lastname: Ruglass
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000534:rehabilitation*; D019970:Cocaine-Related Disorders / Q000534:rehabilitation*; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D008962:Models, Theoretical; D010342:Patient Acceptance of Health Care; D012657:Self-Help Groups; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome
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