Patient-Centered Trauma Treatment

Patient-Centered Trauma Treatment, i.e., treatment delivered by peers with lived-experience,
has the potential to increase access to trauma treatment in underserved communities. This
could positively impact the lives of millions of people as 70% of adults in the U.S have
experienced a traumatic event and the consequences of trauma are devastating and far
reaching, including chronic and comorbid physical and mental health problems. The most known
consequences of trauma include post-traumatic stress disorder (PTSD) and substance use
disorders (SUDs). Seeking Safety (SS) is the most effective evidenced-based treatment for
co-occurring trauma, PTSD and SUDs. While no specific degree or experience level is required
to conduct SS, all the evidence comes from studies using trained clinicians to implement the
treatment, including social workers, psychologists, and psychiatrists. However, these
research findings do not generalize to underserved communities that lack mental health
professionals. Innovative approaches to treatment, such as peer-delivered services, are
required to meet the demand for care in underserved areas. While the benefits of
peer-delivered services have been well-documented in many areas, the value of peers in the
provision of trauma-treatment is unknown. A theoretical basis supports the potential for
peer-delivered trauma-treatment to be effective in addition to the strong therapist-patient
bond, (i.e. therapeutic alliance (TA), which is an important predictor of treatment outcome
and a typical result of peer-patient relationships.

Our research question is whether there is a difference between peer-led SS (PL-SS) groups and
clinician-led SS (CL-SS) groups in improving the lives of people with trauma, PTSD and SUDs?

The investigators have three specific aims:

1. Determine the effectiveness of PL-SS groups compared to CL-SS groups in decreasing
substance use and PTSD symptoms and improving coping skills, overall mental health and
physical health. Hypothesis: PL-SS compared to CL-SS groups will be as effective in
improving outcomes.

2. Compare levels of TA among PL-SS and CL-SS groups and examine the impact of TA on
outcomes.Hypotheses: Levels of TA will be higher and will play more of a role in
impacting outcomes in the PL-SS compared to CL-SS groups.

3. Determine if the standard Seeking Safety Instructor Training (SS-IT) is adequate for
peers. Hypothesis: Peers will identify topics that will enhance the SS-IT.