Twelve-Month Outcomes of Trauma-Informed Interventions for Women With Co-occurring Disorders

Harvard University, Cambridge, Massachusetts, United States
Psychiatric Services (Impact Factor: 2.41). 11/2005; 56(10):1213-22. DOI: 10.1176/
Source: PubMed


Women with co-occurring mental health and substance use disorders frequently have a history of interpersonal violence, and past research has suggested that they are not served effectively by the current service system. The goal of the Women, Co-occurring Disorders, and Violence Study was to develop and test the effectiveness of new service approaches specifically designed for these women.
A quasi-experimental treatment outcome study was conducted from 2001 to 2003 at nine sites. Although intervention specifics such as treatment length and modality varied across sites, each site used a comprehensive, integrated, trauma-informed, and consumer-involved approach to treatment. Substance use problem severity, mental health symptoms, and trauma symptoms were measured at baseline, and follow-up data were analyzed with prospective meta-analysis and hierarchical linear modeling.
A total of 2,026 women had data at the 12-month follow-up: 1,018 in the intervention group and 1,008 in the usual-care group. For substance use outcomes, no effect was found. The meta-analysis demonstrated small but statistically significant overall improvement in women's trauma and mental health symptoms in the intervention relative to the usual-care comparison condition. Analysis of key program elements demonstrated that integrating substance abuse, mental health, and trauma-related issues into counseling yielded greater improvement, whereas the delivery of numerous core services yielded less improvement relative to the comparison group. A few person-level characteristics were associated with increases or decreases in the intervention effect. These neither moderated nor supplanted the effects of integrated counseling.
Outcomes for women with co-occurring disorders and a history of violence and trauma may improve with integrated treatment.

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    • "tual thinking to the data - driven analysis of TIC and its effects . However , this forward movement is blocked by the absence of psycho - metrically strong instruments to evaluate TIC . Within the limited empirical work on TIC , the effects of TIC imple - mentation are typically measured via client - reported out - comes such as symptom indices ( Morrissey et al . , 2005 ) ; program - level metrics such as suspension and expulsion reduction ( Stevens , 2012 ) ; and organizational - level char - acteristics such as treatment environment ( Rivard et al . , 2005 ) . Though these are important outcomes , they are costly and time - consuming to collect and evaluate ."
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