Differential Service Utilization Associated With Trauma-informed Integrated Treatment for Women With Co-occurring Disorders

  • Allison R. Gilbert
  • Marisa E. Domino
  • Joseph P. Morrissey
  • Bradley N. Gaynes
Original Paper

DOI: 10.1007/s10488-011-0362-z

Cite this article as:
Gilbert, A.R., Domino, M.E., Morrissey, J.P. et al. Adm Policy Ment Health (2012) 39: 426. doi:10.1007/s10488-011-0362-z


Women with co-occurring mental health and substance use disorders and trauma histories vary greatly in symptom severity and use of support services. This study estimated differential effects of an integrated treatment intervention (IT) across sub-groups of women in this population on services utilization outcomes. Data from a national study were used to cluster participants by symptoms and service utilization, and then estimate the effect of IT versus usual care on 12-month service utilization for each sub-group. The intervention effect varied significantly across groups, in particular indicating relative increases in residential treatment utilization associated with IT among women with predominating trauma and substance abuse symptoms. Understanding how IT influences service utilization for different groups of women in this population with complex needs is an important step toward achieving an optimal balance between need for treatment and service utilization, which can ultimately improve outcomes and conserve resources.


Co-occurring disorders PTSD Integrated treatment Interventions Service utilization 

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Allison R. Gilbert
    • 1
  • Marisa E. Domino
    • 2
  • Joseph P. Morrissey
    • 3
    • 4
  • Bradley N. Gaynes
    • 5
  1. 1.Department of Psychiatry and Behavioral SciencesDuke University School of MedicineDurhamUSA
  2. 2.Department of Health Policy and Management, Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillUSA
  3. 3.Departments of Health Policy and Management and PsychiatryUniversity of North Carolina at Chapel HillChapel HillUSA
  4. 4.Cecil G. Sheps Center for Health Services ResearchUniversity of North Carolina at Chapel HillChapel HillUSA
  5. 5.Department of Psychiatry, School of MedicineUniversity of North Carolina at Chapel HillChapel HillUSA

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