Enhancing the Seeking Safety group intervention with trauma-sensitive yoga practice: A program evaluation

Murphy, Thomas M.; Dispenza, Franco; Chang, Catherine Y.; Elston, Nikki; Rumsey, Amanda D.; Sinclair, M.; Curtis-Davidson, Rico

doi:10.1016/j.ctcp.2019.03.006

Cited by 7 publications

(4 citation statements)

References 52 publications

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“…Thus, abbreviated SS may represent a strong choice as it takes less time for both patients and providers. More research is needed to identify if pairing SS with additional PTSD and/or substance use treatments, such as pharmacological treatments (Hoskins et al., 2021; Norman et al., 2012), trauma‐focused treatments like cognitive processing therapy (CPT) (Asmundson et al., 2019), or complementary and integrative health (CIH) treatments, such as trauma‐informed yoga (Kelly et al., 2021; Murphy et al., 2019), can improve patient outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…SS has undergone efficacy and effectiveness trials in many variations and by many independent investigators, including (a) individual delivery (e.g., Hien et al., 2004), group delivery (e.g., Boden et al., 2012; Crisanti et al., 2019) (b) integration with pharmacotherapy (Hien et al., 2015) or other treatment modalities (e.g., Murphy et al., 2019; Ragg et al., 2019), (c) delivery by peers and case managers as well as clinicians (Crisanti et al., 2019; Desai et al., 2008), and (d) examination in non‐healthcare settings (e.g., community‐based, jail/prison‐based), with a broad range of racially and ethnically diverse participants. Samples in studies of SS included veterans (Boden et al., 2012; Desai et al., 2008), people with physical disabilities (Anderson & Najavits, 2014), homeless (Desai et al., 2008), incarcerated women and men (Lynch et al., 2012; Zlotnick et al., 2009; Barrett et al., 2015), adolescent girls (Najavits et al., 2006), indigenous populations (Marsh, 2016), pregnant women (Shenai et al., 2019), and transgender women (Empson et al., 2017; Takahashi, 2020).…”

Section: Introductionmentioning

confidence: 99%

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Seeking safety intervention for comorbid post‐traumatic stress and substance use disorder: A meta‐analysis

et al. 2023

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Problem statement: Seeking Safety (SS) is a widely implemented cognitive-behavioral therapy for comorbid post-traumatic stress disorder (PTSD) and substance use disorder (SUD). It is a present-focused coping skills model that is highly flexible, with varied methods of delivery, to maximize acceptability and client access. The purpose of this meta-analysis is to examine the effect of SS on comorbid PTSD and SUD across randomized control trials (RCTs). In addition, ours is the first meta-analysis to examine the dose-response of SS by comparing delivery of all 25 SS topics versus fewer. Methods and design:Articles published before January 2, 2023 (CINAHL n = 16, PsycINFO n = 31, MEDLINE n = 27, Cochrane n = 38, and Scopus n = 618) were searched. Seven studies were included for meta-analysis and dose-response analysis.Results: Based on effect sizes (ES), meta-analysis revealed that SS has a medium group, time (p = .04), and time by group effect on substance use per the Addiction Severity Index at 3 months and a small effect on Clinician-Administered PTSD Scale scores by group, a large effect by time, and a medium time by group (p = .002) effect at 6 months.Based on the pooled ES examining various measures across multiple timepoints, SS had small to medium effects on substance use by time, group, or time by group and medium to large effects on PTSD symptoms by time, group, or time by group (except for the group effect at 3-month follow-up). Significant effects were found for substance use by time at 3 and 6 months and for PTSD postintervention, at 6 months and 9 months by group, time, and time by group while only by time at 3 months. Meta-regression revealed that partial dose versions of SS generally function as well as the full dose version of SS when observing long-term effects (greater than 3 months).Discussion: Findings suggest SS has merit in treating PTSD symptoms and SUD. Based on the summarized effect sizes, SS appears more effective in reducing PTSD than substance use, which converges with the larger treatment outcome literature that

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Seeking safety intervention for comorbid post‐traumatic stress and substance use disorder: A meta‐analysis

et al. 2023

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“…Yoga showed preliminary evidence as a complimentary treatment for PTSD (10)(11)(12). To avoid potentially aversive triggering stimuli, studies combined yoga with common stabilization techniques (13) or used trauma-sensitive yoga approaches (14,15). In contrast to asanas (yoga postures), the effects of pranayama (breathing techniques) are understudied.…”

Section: Introductionmentioning

confidence: 99%

The integration of yoga breathing techniques in cognitive behavioral therapy for post-traumatic stress disorder: A pragmatic randomized controlled trial

2023

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IntroductionIn trauma-focused Cognitive Behavioral Therapy (TF-CBT), stabilization techniques are used before confrontation ones to increase stress/affect tolerance and thus effectiveness of CBT. This study investigated the effects of pranayama, meditative yoga breathing and breath holding techniques, as a complimentary stabilization technique in patients with post-traumatic stress disorder (PTSD).MethodsSeventy-four PTSD-patients (84% female, 44.2 ± 13 years) were randomized to receive either pranayama at the beginning of each TF-CBT session or TF-CBT alone. The primary outcome was self-reported PTSD severity after 10 sessions of TF-CBT. Secondary outcomes included quality of life, social participation, anxiety, depression, distress tolerance, emotion regulation, body awareness, breath-holding duration, acute emotional reaction to stress, and adverse events (AEs). Intention-to-treat (ITT) and exploratory per-protocol (PP) analyses of covariance with 95% confidence intervals (CI) were performed.ResultsITT analyses revealed no significant differences on primary or secondary outcomes, except for breath-holding duration in favor of pranayama-assisted TF-CBT (20.81 s, 95%CI = 13.05|28.60). PP analyses of 31 patients without AEs during pranayama revealed significantly lower PTSD severity (−5.41, 95%CI = -10.17|-0.64) and higher mental quality of life (4.89, 95%CI = 1.38|8.41) than controls. In contrast, patients with AEs during pranayama breath holding reported significantly higher PTSD severity (12.39, 95%CI = 5.08|19.71) than controls. Concurrent somatoform disorders were found to be a significant moderator of change in PTSD severity (p = 0.029).ConclusionIn PTSD patients without concurrent somatoform disorders, the integration of pranayama into TF-CBT might reduce post-traumatic symptoms and increase mental quality of life more efficiently than TF-CBT alone. The results remain preliminary until they can be replicated by ITT analyses.Clinical trial registrationClinicalTrials.gov, identifier NCT03748121.

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“…Ideally, trauma-informed yoga will create a safer environment in which students with a trauma history are supported in exercising choice and developing a friendly, non-antagonistic relationship with their bodies. A trauma-informed approach to yoga may be particularly important when working with vulnerable populations ( Horton, 2017 , p. 51; Murphy et al, 2019 ), as these individuals are more likely to have a history of trauma.…”

Section: Introductionmentioning

confidence: 99%

Program evaluation of trauma-informed yoga for vulnerable populations

Tibbitts

Aicher

Sugg³

et al. 2021

Evaluation and Program Planning

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Background: Trauma is highly prevalent among vulnerable populations, including those who are incarcerated, in treatment for substance use, or seeking mental health services. Trauma-informed yoga seeks to create a safer yoga practice for individuals with a trauma history and may improve emotional and physical wellbeing. Thus, we conducted an evaluation of a trauma-informed yoga program to gain insight into participant experiences. Methods: Trauma-informed yoga classes were led by trained volunteers and held in three sectors that work with vulnerable populations: corrections and reentry, substance use treatment and recovery, and community and mental health. Data were collected via anonymous survey using a retrospective pre-post design. The survey instrument captured reasons for student participation and perceived effects of yoga on emotional and physical wellbeing. Results: Students were motivated to participate in yoga classes by expectations of physical, mental, and spiritual benefit. Students reported perceived improvements in emotional and physical wellbeing and greater use of self-regulation skills after starting yoga. Conclusion: Our findings suggest trauma-informed yoga is perceived as beneficial by vulnerable individuals, especially those in the correctional system or recovering from substance use. Our results support the value of offering trauma-informed yoga in institutionalized and community settings. Improvements in emotional and physical wellbeing warrant formal study.

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Enhancing the Seeking Safety group intervention with trauma-sensitive yoga practice: A program evaluation

Cited by 7 publications

References 52 publications

Seeking safety intervention for comorbid post‐traumatic stress and substance use disorder: A meta‐analysis

Seeking safety intervention for comorbid post‐traumatic stress and substance use disorder: A meta‐analysis

The integration of yoga breathing techniques in cognitive behavioral therapy for post-traumatic stress disorder: A pragmatic randomized controlled trial

Program evaluation of trauma-informed yoga for vulnerable populations

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