DOI: 10.3886/icpsr03416.v1
title: Treatment of Incarcerated Women with Substance Use Disorder and Post-traumatic Stress Disorder in Providence, Rhode Island, 1999-2001
title: Version 1

description: The goal of this study was to evaluate the initial
efficacy, feasibility, and acceptability of Seeking Safety (SS)
treatment in a sample of incarcerated women with comorbid substance
use disorder (SUD) and comorbid post-traumatic stress disorder
(PTSD). Seeking Safety, a cognitive-behavioral psychotherapy
treatment, is a psychosocial treatment for women with comorbid PTSD
and SUD and, at the time this study was conducted, it was the
treatment with the most efficacy data for this population. SS
treatment appears to be a promising intervention for incarcerated
women with PTSD and SUD because (1) the treatment targets many of the
deficits found in this population that may interfere with their
recovery and place these women at risk for reoffending (such as
impulsiveness, anger dyscontrol, and maladaptive lifestyle
activities), and (2) it teaches skills to manage these problematic
behaviors. This study aimed to conduct an open feasibility trial of
Seeking Safety treatment in a sample of six incarcerated women with
SUD and PTSD and to conduct a randomized controlled pilot study to
evaluate the initial efficacy, feasibility, and acceptability of the
proposed treatment as an adjunct to treatment as usual (TAU), compared
to a TAU control group in a sample of 22 incarcerated women with
comorbid PTSD and SUD. The primary hypothesis was that, compared to
the TAU condition, women in the SS treatment condition would have less
severe drug and alcohol use as well as fewer PTSD symptoms and legal
problems after intervention, and at six weeks and three months after
release. The first six participants recruited for the study received
SS group treatment as an adjunct to the treatment provided by the
Discovery Program, the substance abuse treatment program in the
minimum security arm of the Women's Facility of the Adult Correctional
Institution in Providence, Rhode Island. The remaining participants
were randomly assigned to either the control group (TAU) or to a group
that received SS treatment as an adjunct to TAU. The treatment groups
were conducted by clinicians who worked as substance abuse therapists
in the Discovery Program and a clinical psychologist from Brown
University. All SS therapists received training in delivering SS
therapy from Dr. Lisa Najavits, who developed SS
treatment. Assessments were conducted at pretreatment, post-treatment
during incarceration, and three and six months postrelease for
PTSD-related measures. Measures of severity of substance abuse and
legal problems were taken at pretreatment, as well as at the six- and
12-week postrelease intervals. Measures were taken with a variety of
clinical instruments, including the Addiction Severity Index (ASI),
the Structured Clinical Interview for DSM-IV (SCID) module on
substance use, the Clinician Administered Post-Traumatic Stress
Disorder Scale-I (CAPS-I), the Trauma History Questionnaire (THQ), the
Helping Alliance Questionnaire-II (HAQ-II), the Client Satisfaction
Questionnaire, and the End-of-Treatment Questionnaire. Basic
demographic data were also collected from administrative
records. Variables include alcohol, drug, and legal composite scores
at pretreatment and post-treatment, number of relapses, whether the
woman returned to prison, whether the woman lied about substance
abuse, use of particular substances one month prior to prison and
during lifetime, PTSD indicators of frequency and intensity, total
client satisfaction scores, patients' ratings of therapists and
treatment, and trauma scales for crime, sexual abuse, and physical
abuse. Demographic variables include age, ethnic background,
education, first time in prison, the nature of the current conviction,
and number of arrests with convictions.
description: The goal of this study was to evaluate the
 initial efficacy, feasibility, and acceptability of Seeking Safety
 (SS) treatment in a sample of incarcerated women with comorbid
 substance use disorder (SUD) and comorbid post-traumatic stress
 disorder (PTSD). Seeking Safety, a cognitive-behavioral psychotherapy
 treatment, is a psychosocial treatment for women with comorbid PTSD
 and SUD and, at the time this study was conducted, it was the
 treatment with the most efficacy data for this population. SS
 treatment appears to be a promising intervention for incarcerated
 women with PTSD and SUD because (1) the treatment targets many of the
 deficits found in this population that may interfere with their
 recovery and place these women at risk for reoffending (such as
 impulsiveness, anger dyscontrol, and maladaptive lifestyle
 activities), and (2) it teaches skills to manage these problematic
 behaviors. This study aimed to conduct an open feasibility trial of
 Seeking Safety treatment in a sample of six incarcerated women with
 SUD and PTSD and to conduct a randomized controlled pilot study to
 evaluate the initial efficacy, feasibility, and acceptability of the
 proposed treatment as an adjunct to treatment as usual (TAU), compared
 to a TAU control group in a sample of 22 incarcerated women with
 comorbid PTSD and SUD. The primary hypothesis was that, compared to
 the TAU condition, women in the SS treatment condition would have less
 severe drug and alcohol use as well as fewer PTSD symptoms and legal
 problems after intervention, and at six weeks and three months after
release.
description: The first six participants recruited for the study
 received SS group treatment as an adjunct to the treatment provided by
 the Discovery Program, the substance abuse treatment program in the
 minimum security arm of the Women's Facility of the Adult Correctional
 Institution in Providence, Rhode Island. The remaining participants
 were randomly assigned to either the control group (TAU) or to a group
 that received SS treatment as an adjunct to TAU. The treatment groups
 were conducted by clinicians who worked as substance abuse therapists
 in the Discovery Program and a clinical psychologist from Brown
 University. All SS therapists received training in delivering SS
 therapy from Dr. Lisa Najavits, who developed SS treatment. SS
 treatment focuses on developing a specific cognitive, behavioral, or
 interpersonal skill, with each skill designed to combat both SUD and
 PTSD simultaneously. The primary goals of the treatment are abstinence
 from substances and personal safety. Assessments were conducted at
 pretreatment, post-treatment during incarceration, and three and six
 months postrelease for PTSD-related measures. Measures of severity of
 substance abuse and legal problems were taken at pretreatment, as well
 as at the six- and 12-week postrelease intervals. Measures were taken
 with a variety of clinical instruments. The Addiction Severity Index
 (ASI) was used at intake to assess change in the severity of substance
 abuse in the past 30 days. The legal composite score from the ASI was
 used to assess change in criminal activities. The legal composite
 index contained information about arrests, incarcerations, and
 engagement in criminal activity since release from prison. At intake
 the women were assessed for legal problems in the 30 days prior to
 entering prison. The Structured Clinical Interview for the DSM-IV
 (SCID) module on substance use was used to provide a diagnosis of
 alcohol or drug use or dependence. The Clinician Administered
 Post-Traumatic Stress Disorder Scale-I (CAPS-I) provided a diagnosis
 of PTSD as well as an assessment of the degree of PTSD symptoms. To
 assess lifetime history of trauma, the Trauma History Questionnaire
 (THQ) was given at pretreatment. This measure yielded four frequency
 scores for physical, sexual, general disaster, and crime-related
 traumas. At post-treatment the participants' views of treatment were
 assessed on the Helping Alliance Questionnaire-II (HAQ-II) and the
 Client Satisfaction Questionnaire. At post-treatment the patients'
 perceptions of the helpfulness of components of SS treatment were
 assessed with the End-of-Treatment Questionnaire. Basic demographic
 data, such as age, education, and criminal history, were also
collected from administrative records.
description: Variables include alcohol, drug, and legal
 composite scores at pretreatment and post-treatment, number of
 relapses, whether the woman returned to prison, whether the woman lied
 about substance abuse, use of particular substances one month prior to
 prison and during lifetime, PTSD indicators of frequency and
 intensity, total client satisfaction scores, patients' ratings of
 therapists and treatment, and trauma scales for crime, sexual abuse,
 and physical abuse. Demographic variables include age, ethnic
 background, education, first time in prison, the nature of the current
conviction, and number of arrests with convictions.
description: Response Rates: Not applicable.
description: Presence of Common Scales: This data collection includes scales from the Addiction
 Severity Index (McLellan et al., 1992), Structured Clinical Interview
 for DSM-IV (First et al., 1996), Clinician Administered Post-Traumatic
 Stress Disorder Scale-I (Blake et al., 1990), Trauma History
 Questionnaire (Greene, 1995), Helping Alliance Questionnaire-II
 (Luborky et al., 1996), Client Satisfaction Questionnaire (Attkisson
 and Zwick, 1982), and the End-of-Treatment Questionnaire (Najavitis,
1994).
description: Not applicable.
description: Datasets: 
DS1: Treatment of Incarcerated Women with Substance Use Disorder and Post-traumatic Stress Disorder in Providence, Rhode Island, 1999-2001
description: Women inmates suffering from PTSD and SUD in Rhode
Island.
description: Additional information about the clinical scales
used in this data collection can be found in the appendix of the
codebook.