Trauma and substance use among youth: A synthesis of research on the Seeking Safety program and pilot study
This article focuses on post-traumatic stress disorder (PTSD) and substance use disorder (SUD) as a concurrent disorder; a clinical reality frequently found in adults where integrated treatments are recommended as a method of intervention. Among them, the Seeking Safety program (SS) is the most empirically validated. Evidence of its efficacy is now established in an adult population and it is the only treatment that exceeds the control treatment for PTSD and SUD. The work on the French version is also encouraging. Youth, meanwhile, is equally at risk for this type of disorder; the prevalence is estimated between 11% and 47% (community and clinical population). Although psychosocial impacts are important, there is little research on integrated treatment for this population. However, two recent studies demonstrate the efficacy of the SS program for American youth. Adjustments are underway to adapt the program to the reality of adolescents and their parents and facilitate its implementation. Preliminary data were collected from French Canadian youth (18-25 years) who received motivational interviewing sessions combined with SS offered in group (n=6 ) or in individual sessions (n=3). The results show that the French version of the SS program appears to be effective in a group context as significant improvements were noted in the PCL-S, the MAST-22 and also according to the axis 5 of the DSM-IV-TR (large effect sizes). However, no significant improvement was noted for individual care and the DAST-20 in group context; although these measures appear to have evolved in the direction of wellness. This study suggests that the French version of the SS program is promising in the treatment of PTSD-SUD for French-Canadian youth in a clinical context.