Self‐wise, Other‐wise, Streetwise (SOS) training, an intervention to prevent victimization in dual‐diagnosis patients: results from a randomized clinical trial

Background and Aims Patients with co‐occurring substance use and other mental disorders are vulnerable to crime victimization, yet no evidence‐based preventive interventions exist. Our aim was to test the efficacy of a new intervention, Self‐wise, Other‐wise, Streetwise training (SOS training), to p...

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Bibliographic Details
Published in:Addiction (Abingdon, England) England), 2019-04, Vol.114 (4), p.730-740
Main Authors: Waal, Marleen M., Dekker, Jack J. M., Kikkert, Martijn J., Christ, Carolien, Chmielewska, Jaga, Staats, Monique W. M., Brink, Wim, Goudriaan, Anna E.
Format: Article
Language:English
Subjects:
Adult
Assertiveness
Bayesian analysis
Clinical research
clinical trial
Clinical trials
Comorbidity
Conflict resolution
Counseling
co‐occurring disorders
Crime
Crime Victims
Diagnosis
Diagnosis, Dual (Psychiatry)
Drug abuse
Drug therapy
dual diagnosis
Efficacy
Emotional Regulation
Emotions
Evidence-based medicine
Female
Group psychotherapy
Humans
Individual psychotherapy
International crime
Intervention
Male
Medical diagnosis
Mental disorders
Mental Disorders - psychology
Netherlands - epidemiology
Outcome Assessment, Health Care
Patients
Pharmacology
prevention
Psychotherapy
Psychotherapy, Group
Public safety
Research Report
Research Reports
resilience
Safety regulations
Self Concept
Self Report
Single-Blind Method
Skills
Social Skills
Substance use
Substance-Related Disorders - psychology
Training
Victimization
Victims
Victims of crime
violence
Violent crime
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Summary:Background and Aims Patients with co‐occurring substance use and other mental disorders are vulnerable to crime victimization, yet no evidence‐based preventive interventions exist. Our aim was to test the efficacy of a new intervention, Self‐wise, Other‐wise, Streetwise training (SOS training), to prevent victimization in these dual‐diagnosis patients as an add‐on to care as usual. Design Multi‐site single‐blind parallel randomized controlled trial. Setting Three sites within one psychiatric service in Amsterdam, the Netherlands. Participants Adult in‐patients and out‐patients with dual diagnosis (n = 250), who were predominantly male (70.4%), aged on average 42.1 years, and diagnosed with 3.7 DSM‐IV disorders. Intervention and comparator Care as usual, consisting of pharmacotherapy combined with individual psychotherapy, group psychotherapy and/or supportive counselling (n = 125) was compared with care as usual plus SOS training: a 6‐week, 12‐session manualized group training focused on enhancing emotion regulation skills, conflict resolution skills and street skills (n = 125). Measurements Victimization was assessed with the Safety Monitor, the Dutch equivalent of the International Crime Victims Survey, in a face‐to‐face assessment. The primary outcome measure was treatment response (yes/no), with ‘yes’ defined as reporting at least a 50% reduction in the number of past‐year victimization incidents at the 14‐month follow‐up compared with baseline. Analyses were performed according to the intention‐to‐treat principle. Findings The proportion of participants achieving treatment response for total victimization was 54.0% in the control group and 67.6% in the experimental group, a significant difference [odds ratio (OR) = 1.78, 95% confidence interval (CI) = 1.02–3.11, P = 0.042]. Treatment response for violent victimization was achieved by 68.7% of the control group and 79.3% of the experimental group (OR = 1.75, 95% CI = 0.91–3.34, P = 0.092). With a Bayes factor of 2.26, this result was inconclusive. Conclusions Among dual‐diagnosis patients, care as usual plus Self‐wise, Other‐wise, Streetwise training was more effective in preventing victimization than care as usual alone.
ISSN:0965-2140
1360-0443
DOI:10.1111/add.14500