Treating the trauma of rape: cognitive-behavioral therapy for PTSD
In: Treatment manuals for practitioners
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In: Treatment manuals for practitioners
In: Intervention, Band 7, Heft 3, S. 204-222
In: Journal of social and biological structures: studies in human sociobiology, Band 5, Heft 2, S. 189-198
ISSN: 0140-1750
In: Human relations: towards the integration of the social sciences, Band 25, Heft 4, S. 337-350
ISSN: 1573-9716, 1741-282X
In: Social work in health care: the journal of health care social work ; a quarterly journal adopted by the Society for Social Work Leadership in Health Care, Band 54, Heft 8, S. 687-707
ISSN: 1541-034X
In: Child abuse & neglect: the international journal ; official journal of the International Society for the Prevention of Child Abuse and Neglect, Band 37, Heft 9, S. 675-678
ISSN: 1873-7757
In: Journal of family violence, Band 29, Heft 5, S. 559-566
ISSN: 1573-2851
In: Social work in mental health: the journal of behavioral and psychiatric social work, Band 12, Heft 5-6, S. 482-499
ISSN: 1533-2993
In: Psychological services, Band 21, Heft 2, S. 214-223
ISSN: 1939-148X
OBJECTIVE: A substantial amount of individuals with substance use disorders (SUD) also meet criteria for posttraumatic stress disorder (PTSD). Prolonged exposure (PE) is an effective, evidenced-based treatment for PTSD, but there is limited data on its use among individuals with current alcohol or drug use disorders. This study evaluated the efficacy of an integrated treatment that incorporates PE (Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure or COPE) among veterans. METHOD: Military veterans (N = 81, 90.1% male) with current SUD and PTSD were randomized to 12 sessions of COPE or Relapse Prevention (RP). Primary outcomes included the Clinician-Administered PTSD Scale (CAPS), PTSD Checklist-Military version (PCL-M), and the Timeline Follow-back (TLFB). RESULTS: On average, participants attended 8 out of 12 sessions and there were no group differences in retention. Intent-to-treat analyses revealed that COPE, in comparison to RP, resulted in significantly greater reductions in CAPS (d = 1.4, p <. 001) and PCL-M scores (d = 1.3, p = .01), as well as higher rates of PTSD diagnostic remission (OR = 5.3, p < .01). Both groups evidenced significant and comparable reductions in SUD severity during treatment. At 6-months follow-up, participants in COPE evidenced significantly fewer drinks per drinking day than participants in RP (p = .05). CONCLUSIONS: This study is the first to report on the use of an integrated, exposure-based treatment for co-occurring SUD and PTSD in a veteran sample. The findings demonstrate that integrated, exposure-based treatments are feasible and effective for military veterans with SUD and PTSD. Implications for clinical practice are discussed.
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This randomized trial compared the effects of prolonged exposure therapy (10 sessions over 2 weeks vs 8 weeks) vs present-centered therapy vs minimal contact on posttraumatic stress disorder (PTSD) symptom severity among active duty military personnel.
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