scholarly journals Concurrent treatment of substance use disorders and PTSD using prolonged exposure: A randomized clinical trial in military veterans

2019 ◽  
Vol 90 ◽  
pp. 369-377 ◽  
Author(s):  
Sudie E. Back ◽  
Therese Killeen ◽  
Christal L. Badour ◽  
Julianne C. Flanagan ◽  
Nicholas P. Allan ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Substance Use ◽  
Randomized Clinical Trial ◽  
Substance Use Disorders ◽  
Prolonged Exposure ◽  
Military Veterans ◽  
Concurrent Treatment

scholarly journals When Research Meets Reality–-Lessons Learned from a Pragmatic Multisite Group-Randomized Clinical Trial on Psychosocial Interventions in the Psychiatric and Addiction Field

2012 ◽  
Vol 6 ◽  
pp. SART.S9245 ◽  
Author(s):  
Linda E. Wüsthoff ◽  
Helge Waal ◽  
Rolf W. Gråwe
Keyword(s):  
Clinical Trial ◽  
Substance Use ◽  
Randomized Clinical Trial ◽  
Substance Use Disorders ◽  
Clinical Studies ◽  
Psychosocial Interventions ◽  
Integrated Treatment ◽  
Lessons Learned ◽  
Future Research ◽  
New Challenges

Research on treatments for patients with co-occurring psychiatric and substance use disorders is of core importance and at the same time highly challenging as it includes patients that are normally excluded from clinical studies. Such research may require methodological adaptations which in turn create new challenges. However, the challenges that arise in such studies are insufficiently discussed in the literature. The aim of this methodology paper is, firstly, to discuss the methodological adaptations that may be required in such research; secondly, to describe how such adaptations created new challenges in a group-randomized clinical trial on Integrated Treatment amongst patients with co-occurring psychiatric and substance use disorders. We also discuss how these challenges might be understood and highlight lessons for future research in this field. Trial registration: NCT00447733.

scholarly journals Does trauma-focused exposure therapy exacerbate symptoms among patients with comorbid PTSD and substance use disorders?

2019 ◽  
Vol 48 (1) ◽  
pp. 38-53
Author(s):  
Cynthia L. Lancaster ◽  
Daniel F. Gros ◽  
Michael C. Mullarkey ◽  
Christal L. Badour ◽  
Therese K. Killeen ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Prolonged Exposure ◽  
Exposure Therapy ◽  
Psychological Symptoms ◽  
Depression Symptoms ◽  
Post Traumatic Stress ◽  
Concurrent Treatment ◽  
Symptom Exacerbation ◽  
Post Traumatic

AbstractBackground: Although exposure-based therapy is a well-established, effective treatment for post-traumatic stress disorder (PTSD), some practitioners report reluctance to implement it due to concerns that it may exacerbate symptoms of PTSD and commonly comorbid disorders, such as substance use disorders (SUD).Aim: This study compared the exacerbation of psychological symptoms among participants with comorbid PTSD and SUD who received either SUD treatment alone or SUD treatment integrated with exposure therapy for PTSD.Method: Participants (N = 71) were treatment-seeking, military Veterans with comorbid PTSD and SUD who were randomized to 12 individual sessions of either (1) an integrated, exposure-based treatment (Concurrent Treatment of PTSD and Substance Use Disorders using Prolonged Exposure; COPE); or (2) a non-exposure-based, SUD-only treatment (Relapse Prevention; RP). We examined between-group differences in the frequency of statistically reliable exacerbations of PTSD, SUD and depression symptoms experienced during treatment.Results: At each of the 12 sessions, symptom exacerbation was minimal and generally equally likely in either treatment group. However, an analysis of treatment completers suggests that RP participants experienced slightly more exacerbations of PTSD symptoms during the course of treatment.Conclusions: This study is the first to investigate symptom exacerbation throughout trauma-focused exposure therapy for individuals with comorbid PTSD and SUD. Results add to a growing literature which suggests that trauma-focused, exposure-based therapy does not increase the risk of symptom exacerbation relative to non-exposure-based therapy.

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