Effectiveness of Seeking Safety on Reducing PTSD and Substance Use: A Review

Abstract

Background and Purpose: The Seeking Safety intervention was created to treat co-occurring substance use disorder (SUD) and posttraumatic stress disorder (PTSD). The prevalence of individuals experiencing comorbid PTSD and SUD was estimated to range between 21% and 43%. Researchers have conducted randomized controlled trials (RCT) testing the effectiveness of Seeking Safety on PTSD and substance use outcomes. The current literature lacks a synthesis of results from multiple RCT studies of Seeking Safety in a consolidated review. This study’s purpose was to examine the effectiveness of the Seeking Safety intervention on reducing PTSD symptoms and substance use. Specifically, the study sought to answer the following research questions: 1) Following exposure to Seeking Safety, are PTSD symptoms more reduced compared to other treatments? 2) Do drug screens reveal a greater decrease in substance use following Seeking Safety compared to other treatments? 3) Do participants’ self-report measures indicate a greater decrease in substance use following Seeking Safety compared to other treatments?

Methods: We conducted a search of the “Seeking Safety” website for studies reporting randomized controlled trials. We also conducted an advanced search on the Florida State University Library Website for similar studies. Our inclusion criteria consisted of randomized controlled trials of the Seeking Safety intervention with women and/or men over the age of 18 receiving treatment in either residential or outpatient settings. Any studies that included youth under the age of 18 were excluded. Additionally, we only included studies that were published in English, and we excluded the gray literature. After careful review of the studies found in our search, we selected eight studies that met criteria. We examined the eight studies for findings of results on Seeking Safety’s effectiveness on reducing PTSD symptoms and substance use compared to other treatments.

Results: Results suggested that out of the eight RCTs examined in this review, seven of the studies revealed findings that did not support any of our three hypotheses pertaining to the presumptive superior effects of Seeking Safety. One study’s findings supported our first hypothesis indicating Seeking Safety reduced PTSD symptoms more than the alternative treatment. The effectiveness of Seeking Safety in reducing substance use was not tested in that study. The majority of the RCTs included in this review found that Seeking Safety was effective at reducing PTSD symptoms and substance use. However, Seeking Safety was not more effective in reducing PTSD symptoms and substance use compared to alternative treatments.

Conclusions and Implications: Overall, the majority of findings concluded Seeking Safety was effective at reducing PTSD symptoms and substance use, but no differences were found when comparing the results of Seeking Safety treatment groups to alternative treatment groups. Limitations of this study included only conducting a review of randomized controlled trials of Seeking Safety that met our inclusion criteria. The findings of this study suggest future research should include further analyses of the Seeking Safety intervention to assess its effectiveness in treating co-occurring PTSD and SUD as this intervention is directed toward improving outcomes for marginalized and vulnerable populations.