Research has demonstrated a significant relationship between interpersonal trauma (physical or sexual abuse) and mental health and substance use disorders. This study, based on data from a national, multi-site trial, examined the impact of an intervention that integrated care for these disorders among 2729 women with varying levels of symptom severity.

Integrated care, consisting of 12 to 33 brief group sessions that were not standardized across sites, was compared with usual care. Severity of post-traumatic stress disorder (PTSD) and substance use symptoms was determined with standardized instruments.

• In most instances, both the intervention and control groups showed improvements in their PTSD symptoms, alcohol and drug problems, and mental health problems over a year.
• Improvements were generally greater in the intervention group, particularly among women with the most severe PTSD and substance use symptoms.
• However, the intervention had little effect on women with the least severe symptoms.

Comments by Norma Finkelstein, Ph.D., LICSW
This study provides a valuable look at the issue of targeting trauma interventions and is particularly important because studies of trauma interventions for women with co-occurring disorders are rare. The impact of the intervention was similar to that reported in other PTSD intervention studies. But, given the preliminary and exploratory nature of the original study, the authors' conclusion to reserve integrated trauma-related interventions to women with the most severe symptoms seems premature.

Also, it is important to note that this study did not compare specific trauma interventions (sites were free to choose one from several models). The field would benefit immensely from additional well-designed experimental studies on this critical issue.