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

Abstract

Background and AimsPatients 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.DesignMulti‐site single‐blind parallel randomized controlled trial.SettingThree sites within one psychiatric service in Amsterdam, the Netherlands.ParticipantsAdult 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 comparatorCare 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).MeasurementsVictimization 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.FindingsThe 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.ConclusionsAmong dual‐diagnosis patients, care as usual plus Self‐wise, Other‐wise, Streetwise training was more effective in preventing victimization than care as usual alone.