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We report on a randomized controlled trial comparing the effect of integrated cognitive\u2013behavioral therapy (ICBT) plus standard care, individual addiction counseling plus standard care and standard care alone on substance use and PTSD symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Three\u2010group, multi\u2010site randomized controlled trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Seven addiction treatment programs in Vermont and New Hampshire, USA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants\/Cases<\/jats:title><jats:p>Recruitment took place between December 2010 and January 2013. In this single\u2010blind study, 221 participants were randomized to one of three conditions: ICBT plus standard care (SC) (<jats:italic>n<\/jats:italic>\u2009=\u200973), individual addiction counseling (IAC) plus SC (<jats:italic>n<\/jats:italic>\u2009=\u200975) or SC only (<jats:italic>n<\/jats:italic>\u2009=\u200973). One hundred and seventy\u2010two patients were assessed at 6\u2010month follow\u2010up (58 ICBT; 61 IAC; 53 SC). Intervention and comparators: ICBT is a manual\u2010guided therapy focused on PTSD and substance use symptom reduction with three main components: patient education, mindful relaxation and flexible thinking. IAC is a manual\u2010guided therapy focused exclusively on substance use and recovery with modules organized in a stage\u2010based approach: treatment initiation, early abstinence, maintaining abstinence and recovery. SC are intensive out\u2010patient program services that include 9\u201312 hours of face\u2010to\u2010face contact per week over 2\u20134 days of group and individual therapies plus medication management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Primary outcomes were PTSD severity and substance use severity at 6\u2009months. Secondary outcomes were therapy retention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>PTSD symptoms reduced in all conditions with no difference between them. In analyses of covariance, ICBT produced more favorable outcomes on toxicology than IAC or SC [comparison with IAC, parameter estimate: 1.10; confidence interval (CI)\u2009=\u20090.17\u20132.04; comparison with SC, parameter estimate: 1.13; CI\u2009=\u20090.18\u20132.08] and had a greater reduction in reported drug use than SC (parameter estimate: \u20139.92; CI\u2009=\u2009\u201318.14\u2009to\u2009\u20131.70). ICBT patients had better therapy continuation versus IAC (<jats:italic>P<\/jats:italic>&lt;0.001). There were no unexpected or study\u2010related adverse events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Integrated cognitive behavioral therapy may improve drug\u2010related outcomes in post\u2010traumatic stress disorder sufferers with substance use disorder more than drug\u2010focused counseling, but probably not by reducing post\u2010traumatic stress disorder symptoms to a greater extent.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.12943","type":"journal-article","created":{"date-parts":[[2015,4,6]],"date-time":"2015-04-06T22:19:19Z","timestamp":1428358759000},"page":"1194-1204","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":58,"title":["A randomized controlled trial of treatments for co\u2010occurring substance use disorders and post\u2010traumatic stress disorder"],"prefix":"10.1111","volume":"110","author":[{"given":"Mark P.","family":"McGovern","sequence":"first","affiliation":[{"name":"Department of Psychiatry Geisel School of Medicine at Dartmouth  Lebanon NH USA"},{"name":"Department of Community and Family Medicine Geisel School of Medicine at Dartmouth  Lebanon NH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chantal","family":"Lambert\u2010Harris","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Geisel School of Medicine at Dartmouth  Lebanon NH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiyi","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Community and Family Medicine Geisel School of Medicine at Dartmouth  Lebanon NH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Meier","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Geisel School of Medicine at Dartmouth  Lebanon NH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bethany","family":"McLeman","sequence":"additional","affiliation":[{"name":"Dartmouth Psychiatric Research Center Geisel School of Medicine at Dartmouth  Lebanon NH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Saunders","sequence":"additional","affiliation":[{"name":"Dartmouth Psychiatric Research Center Geisel School of Medicine at Dartmouth  Lebanon NH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,6,12]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.149.5.664"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/comp.2001.21219"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198712243172604"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1037\/h0080151"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1995.03950240066012"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0963-7214.2004.00309.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/0306-4603(94)00060-3"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.3928\/0048-5713-20010501-10"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.158.8.1184"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.155.2.214"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2005.11.010"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1037\/0893-164X.11.1.34"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2004.08.017"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2012.01.004"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/10550490050172227"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2004.08.016"},{"key":"e_1_2_8_18_1","volume-title":"Integrated Treatment for Dual Disorders: A Guide to Effective Practice","author":"Mueser K. 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