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This article presents findings from a quasi-experimental, nonrandomized group design study that explored whether trauma-enhanced substance abuse treatment results in longer residential treatment stays and improved outcomes compared with treatment-as-usual. We used a subsample (N = 461) of participants in the Women, Co-Occurring Disorders and Violence Study, which was sponsored by the Substance Abuse and Mental Health Services Administration. The intervention group was 31% less likely to discontinue treatment within 4 months. Baseline mental health and trauma symptoms and alcohol and drug severity scores predicted neither overall length of time in treatment nor differences in retention between intervention and comparison groups. Substance abuse and mental health symptoms improved with increased duration of treatment, particularly for women with more severe baseline symptoms. © 2007 Wiley Periodicals, Inc. J Comm Psychol 35: 845–862, 2007.

Effectiveness of an integrated trauma-informed approach to treating women with co-occurring disorders and histories of trauma was evaluated. Baseline and 12-month assessments were completed by 136 intervention- and 177 comparison-group women. The intervention group received Seeking Safety, a trauma-specific group treatment focusing on safety and coping skills, in the context of integrated substance abuse and mental health services. The comparison group received similar services but not trauma-specific group treatment. Intervention women showed significantly better treatment retention over three months and greater improvement on posttraumatic stress symptoms and coping skills. On most outcomes, those who completed treatment improved more than those who discontinued. Improvements on symptoms of distress and drug problem severity were partially mediated by gains in coping skills. © 2007 Wiley Periodicals, Inc. J Comm Psychol 35: 863–878, 2007.

from the Department of Health and Human Services, Public Health Service, Substance Abuseand Mental Health Services Administration’s three centers: Center for Substance Abuse Treatment,Center for Mental Health Services, and Center for Substance Abuse Prevention ~March 2000!.The views expressed in this article represent the personal views of the authors and do not necessarilyrepresent the views of the sponsoring agency.The contributions of project staff at the following participating sites ~listed in alphabetical order by state!are gratefully acknowledged: PROTOTYPES Systems Change Center ~Los Angeles, California!, Vivian Brown,Principal Investigator; Allies: An Integrated System of Care ~Stockton, California!, Jennie Heckman,Principal Investigator; Arapahoe House-New Directions for Families ~Thornton, Colorado!, NancyVanDeMark, Principal Investigator; District of Columbia Trauma Collaboration Study ~Washington, DC!,Roger Fallot, Principal Investigator; Triad Women’s Project ~Avon Park, Florida!, Margo Fleisher-Bond,Co-Principal Investigator, Colleen Clark, Co-Principal Investigator; Boston Consortium of Services for Fam-ilies in Recovery ~Boston, Massachusetts!, Hortensia Amaro, Principal Investigator; Women Embracing Lifeand Living ~WELL! Project ~Cambridge, Massachusetts!, Norma Finkelstein, Principal Investigator; FranklinCounty Women’s Research Project ~Greenfield, Massachusetts!, Rene Andersen, Principal Investigator; Por-tal Project ~New York, New York!, Sharon Cadiz, Principal Investigator. The Coordinating Center wasoperated by Policy Research Associates, located in Delmar, New York, in coordination with the NationalCenter on Family Homelessness in Newton, Massachusetts and the Cecil G. Sheps Center for HealthServices Research at the University of North Carolina in Chapel Hill. Finally, we wish to acknowledge thecontributions of the women who participated in the evaluation.Correspondence to: Margaret Gatz, Department of Psychology, University of Southern California, LosAngeles, CA 90089-1061, e-mail: gatz@usc.edu.

Suicide rates are higher in rural than in urban areas in the United States. One explanation that is frequently offered is scarcity of health and mental health treatment providers in rural areas. The current study tested whether number of providers per capita would explain differences in urban and rural suicide rates within the counties of California, using data from 1993-2001. Results indicate suicide rates were higher in more rural counties, entirely due to higher rural rates among European Americans. Findings also confirmed that there were fewer physicians and mental health care providers per capita in rural areas. Nonetheless, number of providers per capita was not related to suicide rates and thus could not explain the rural-urban differential in suicide rates.

In this article, we describe types of physical and sexual abuse that women report and some consequences of these experiences in their lives. Research questions focused on types of abuse, the age at which abuse was experienced, and correlations between abuse and other outcomes. Data were collected from 2,729 participants in the Women, Co-Occurring Disorders and Violence Study. Results showed that two thirds of participants described their sexual and/or physical abuse as beginning before age 18. Earlier onset was related to more severe current mental distress on the Brief Symptom Inventory. In general, reported age of onset for sexual and/or physical abuse was before onset of substance use. The implication for treatment of mental health disorders and substance use disorders is that interventions that account for abuse and its correlates may be more successful than interventions that do not assess for or attend to issues of abuse. © 2005 Wiley Periodicals, Inc. J Comm Psychol 33: 479–493, 2005.

Using data from a common cross-site protocol administered at study enrollment, in this article we examine key characteristics of 2,729 participants in the Women, Co-Occurring Disorders and Violence Study (WCDVS), including demographics, physical health, mental health, substance abuse, trauma experiences, parenting status, and past history of service use. These data are important because they represent the first federal initiative that addresses the significant lack of appropriate services for women with co-occurring substance use and mental health disorders who have experienced trauma. Study findings reveal a very vulnerable population with extensive histories of abuse and substantial physical and mental health service needs. Data suggest a pressing need for increased availability of physical and mental health services capable of serving the complex needs of women with co-occurring disorders and histories of interpersonal violence (physical and/or sexual abuse). Equally important are funding strategies to support needed services. © 2005 Wiley Periodicals, Inc. J Comm Psychol 33: 429–443, 2005.

This study evaluated Going for the Goal (GOAL), a school-based intervention designed by Danish and colleagues to teach life skills to at-risk urban adolescents. We extended previous evaluation of GOAL by including an assessment of means-ends problem-solving skills. The 10-week program was administered to 479 middle school students by 46 trained high school student leaders in a predominantly Hispanic community. The program focused on setting positive, reachable goals; anticipating and responding to barriers to goal attainment; using social support; and building on one's strengths. Results demonstrated gains in knowledge of the skills being taught and improvement in problem-solving skills. Leaders also showed an increase in their knowledge of life skills. The approach maximizes both community resources and ecological validity while giving high school leaders the chance to benefit in their role as helpers. © 2002 Wiley Periodicals, Inc.

Phyllis Amaral This critical review is focused on six selected issues relevant to those programs in which older paraprofessionals work with their elderly peers: (a) the overall emphasis on preventive mental health benefits for the helpers via the provision of meaningful roles; (b) the range of roles of older paraprofessionals, including peer counseling, casework and outreach, community organization and gerontological advocacy, and other adjunctive roles in agencies; (c) the wide diversity in recruitment, selection, and training practices; (d) the rationale of indigenousness or helper-helpce age similarity as uniquely enhancing the effectiveness of older paraprofessionals; (e) the marginal integration of elderly paraprofessional programs into the mental health system; and (f) the paucity of program outcome evaluations. In considering each issue, an attempt is made to focus on embedded empirical concerns and the continuing need for establishing a research-oriented literature commensurate with the recent growth of clinical and community interest in elderly peer paraprofessional strategies.