title: Seeking Safety Pilot Outcome Study at Walter Reed National Military Medical Center.
abstract: Post-traumatic stress disorder (PTSD) and substance use disorder are two of the most prominent psychiatric disorders among military service members. Seeking Safety (SS) is an evidence-based behavioral therapy model for this comorbidity. This article reports results of a study of SS conducted in a military setting. Our pilot trial addressed outcomes, feasibility, and satisfaction. SS was conducted as is to evaluate its impact without adaptation for military culture. The sample was 24 outpatient service members (from the Army, Navy, Air Force, and Marines) with 33% minority representation. Inclusion criteria were current PTSD and/or SUD. Ten clinicians participated in this study after receiving SS training. Results showed significant improvements on most outcomes, including substance use on the Brief Addiction Monitor; PTSD symptoms on the PTSD Checklist-Military Version (total and criterion D); and the Trauma Symptom Checklist-40 (sexual abuse trauma index and anxiety subscale); functioning on the Sheehan Disability Scale (total and family subscale); psychopathology on the Zung Depression Scale total; the Behavior and Symptom Identification Scale (BASIS)-24 (total and subscales depression functioning, emotional liability, and psychosis); and the Brief Symptom Inventory-18 (total and anxiety subscale); and coping on the Coping Self-Efficacy Scale (total). Satisfaction was strong. Discussion includes methodology limitations and next steps.
authors.affiliation: Treatment Innovations, 28 Westbourne Road, Newton Centre, MA 02459.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Najavits
authors.affiliation: Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20889.
authors.forename: R Gregory
authors.initials: RG
authors.lastname: Lande
authors.affiliation: Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20889.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Gragnani
authors.affiliation: Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20889.
authors.forename: Debra
authors.initials: D
authors.lastname: Isenstein
authors.affiliation: University of California, San Francisco, 500 Parnassus Avenue, San Francisco, CA 94143.
authors.forename: Martha
authors.initials: M
authors.lastname: Schmitz
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000295:instrumentation* / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology*; D063868:Patient Outcome Assessment; D010865:Pilot Projects; D015397:Program Evaluation / Q000379:methods*; D011594:Psychometrics / Q000295:instrumentation / Q000379:methods; D013313:Stress Disorders, Post-Traumatic / Q000628:therapy; D019966:Substance-Related Disorders / Q000628:therapy