Implementation and effectiveness of integrated trauma and addiction treatment for incarcerated men

Nancy Wolff, Jessica Huening, Jing Shi, B. Christopher Frueh, Donald Hoover, Gregory McHugo

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

A controlled trial of Seeking Safety (SS) and Male-Trauma Recovery Empowerment Model (M-TREM) examined implementation and effectiveness of integrated group therapy for comorbid post-traumatic stress disorder (PTSD) and substance use disorder (SUD) on PTSD and mental health symptoms plus self-esteem and efficacy for incarcerated men. The study sample (n= 230) was male inmates 18 years or older who were primarily non-white, high school graduates or equivalents, had childhood trauma histories, committed violent crimes, had serious mental illnesses, and resided in a maximum security prison. Incarcerated men, who screened positive for PTSD and SUD, were assigned randomly (n= 142) or by preference (n= 88) to receive SS or M-TREM, with a waitlist group of (n= 93). Manualized interventions were group-administered for 14 weeks. Primary outcomes were PTSD and other mental health symptoms. Secondary outcomes were self-esteem, coping, and self-efficacy. SUD outcomes cannot be measured in a correctional setting. Implementation feasibility was exhibited by the ability to recruit, screen, assign, and retain participants. Effectiveness findings depended on sample, design, and method for analysis. Using a waitlist control group and no follow-up period, we found no aggregate effect of treatment on PTSD symptoms, although, when disaggregated, M-TREM was found to improve PTSD severity and SS improved general mental health symptoms and psychological functioning. Using intent-to-treat and completer analyses, no significant differences were found in the relative performance between SS and M-TREM on primary or secondary outcomes. When longitudinal data were maximized and modeled in ways that reflect the hierarchical nature of the data, we found that SS and M-TREM performed better than no treatment on PTSD severity and secondary outcomes, and that treatment benefits endured. Findings cautiously support implementing either Seeking Safety or M-TREM to treat incarcerated men with co-morbid PTSD and addiction problems.

Original languageEnglish (US)
Pages (from-to)66-80
Number of pages15
JournalJournal of Anxiety Disorders
Volume30
DOIs
StatePublished - Mar 1 2015

Fingerprint

Post-Traumatic Stress Disorders
Wounds and Injuries
Safety
Substance-Related Disorders
Mental Health
Self Efficacy
Therapeutics
Self Concept
Aptitude
Prisons
Crime
Group Psychotherapy
Power (Psychology)
Psychology
Control Groups

All Science Journal Classification (ASJC) codes

  • Clinical Psychology
  • Psychiatry and Mental health

Keywords

  • Incarcerated men
  • Integrated treatment
  • PTSD
  • Seeking safety
  • Trauma recovery and empowerment model (MTREM)

Cite this

Wolff, Nancy ; Huening, Jessica ; Shi, Jing ; Frueh, B. Christopher ; Hoover, Donald ; McHugo, Gregory. / Implementation and effectiveness of integrated trauma and addiction treatment for incarcerated men. In: Journal of Anxiety Disorders. 2015 ; Vol. 30. pp. 66-80.
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Implementation and effectiveness of integrated trauma and addiction treatment for incarcerated men. / Wolff, Nancy; Huening, Jessica; Shi, Jing; Frueh, B. Christopher; Hoover, Donald; McHugo, Gregory.

In: Journal of Anxiety Disorders, Vol. 30, 01.03.2015, p. 66-80.

Research output: Contribution to journalArticle

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