A Mobile App for Peer-led Seeking Safety
Condition: Substance Use Disorders; PTSD; Trauma; Emotional Dysfunction
MeSH terms: Substance-Related Disorders
Study type: Interventional

Summary: 
      Peer support is historically prominent for substance use disorder (SUD), such as the
      world-wide model of Alcoholics Anonymous and other 12-step groups. Yet for trauma and
      posttraumatic stress disorder (PTSD) there have been few attempts at peer help. A major
      challenge of trauma peer groups is that they usually focus on telling the story of members'
      trauma histories, which can be overly triggering and distressing. Seeking Safety offers an
      excellent choice for peer-led care. It is an evidence-based and is the most widely adopted
      model for SUD/PTD. It is present-focused, cognitive-behavioral, and provides psychoeducation
      and coping skills to help clients attain greater safety in their lives. It has been
      successfully implemented in peer-led format for many years and has been studied in various
      trials, including a recent randomized controlled trial (RCT) comparing peer versus
      professional delivery, with positive results. In Phase 1 we developed a beta version of a
      mobile app for peer-led Seeking Safety (PLSS). In Phase 2 we will enhance the app features
      and content and also conduct an RCT in a sample of adults with current SUD/PTSD to compare
      the Peer Safety app condition to a control app.
    

Detailed description: 
      Peers are increasingly recognized as an important asset in healthcare. Peer support is
      historically most prominent for substance use disorder (SUD), such as the world-wide model of
      Alcoholics Anonymous and other 12-step groups. Yet for trauma and posttraumatic stress
      disorder (PTSD) there have been few attempts at peer help. A major challenge of trauma peer
      groups is that they usually focus on telling the story of members' trauma histories, which
      can be overly triggering and distressing. Seeking Safety offers an excellent choice for
      peer-led care. It is an evidence-based and is the most widely adopted model for SUD/PTD. It
      is present-focused, cognitive-behavioral, and provides psychoeducation and coping skills to
      help clients attain greater safety in their lives-- safety from unsafe behavior toward
      themselves and others, substance use, and trauma symptoms. It has been successfully
      implemented in peer-led format for many years and has been studied in various trials,
      including a recent randomized controlled trial (RCT) comparing peer versus professional
      delivery, with positive results. In Phase 1 we developed a beta version of a mobile app for
      peer-led Seeking Safety (PLSS). The Peer Safety (PS) app was based on extensive input from
      end users and was evaluated in a feasibility study. We found strong positive results in Phase
      1 and are now conducting a Phase 2 project to continue this work. In Phase 2 we are enhancing
      the app features and content and will also conduct an RCT in a sample of adults with current
      SUD/PTSD to compare the PS app condition to a control app. They will have 12 weeks to use the
      app and participate in weekly online PLSS, and will be assessed pre, post and at 3-month
      followup using validated instruments. We will also measure app usage and satisfaction. The
      primary outcomes are substance use and trauma symptoms. Our public health goal is to leverage
      technology to create PLSS in an online environment that would support recovery, powered by
      highly engaging content and delivery. The PS app could address the need for access in remote
      locations, for anonymous help, and for convenient, low-cost help, delivered by people who
      share their experiences as peers. Even for those who do attend in-person modalities, the app
      can provide additional support and unique features. This project proposes a novel technology
      solution to provide care for an important population-- people with SUD/PTSD.
    

Intervention name(s): Peer-Led Seeking Safety app; Control app
Intervention type(s): Behavioral; Behavioral
Intervention description(s): This app offers participants sessions of Seeking Safety plus enhanced app features designed to engage and sustain participants in their recovery work.; This app offers the Seeking Safety content but without the enhanced features
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Supportive Care