What is Seeking Safety Therapy?
About Seeking Safety from the Seeking Safety Official Site:
Seeking Safety is an evidence-based, present-focused counseling model to help people attain safety from trauma and/or substance abuse. It directly addresses both trauma and addiction, but without requiring clients to delve into the trauma narrative (the detailed account of disturbing trauma memories), thus making it relevant to a very broad range of clients and easy to implement. Any clinician can conduct it even without training as it is an extremely safe model; however, there are also many options for training.
You can access reviews of the Seeking Safety book by Marsha Linehan, Aaron Beck, and others; download a book chapter that summarizes the model, and access examples of full chapters (topics). There is also a brief summary about Seeking Safety. Seeking Safety was begun in 1992 under grant funding from the National Institute on Drug Abuse. It was developed by Lisa M. Najavits, PhD at Harvard Medical School and McLean Hospital. It has been used in many countries and has been translated into over 8 languages.
Seeking Safety is a present-focused therapy to help people attain safety from co-occurring PTSD and substance abuse. The treatment is available as a book, providing both client handouts and guidance for clinicians.
The treatment was designed for flexible use. It has been conducted in group and individual format; for women, men, and mixed-gender; using all topics or fewer topics; in a variety of settings (e.g., outpatient, inpatient, residential); and for both substance abuse and dependence. It has also been used with people who have a trauma history, but do not meet criteria for PTSD.
Seeking Safety consists of 25 topics that can be conducted in any order:
Introduction/Case Management, Safety, PTSD: Taking Back Your Power, When Substances Control You, Honesty, Asking for Help, Setting Boundaries in Relationships, Getting Others to Support Your Recovery, Healthy Relationships, Community Resources, Compassion, , Creating Meaning, Discovery, Integrating the Split Self, Recovery Thinking, Taking Good Care of Yourself, Commitment, Respecting Your Time, Coping with Triggers, Self-Nurturing, Red and Green Flags, Detaching from Emotional Pain (Grounding). Life Choices, and Termination.
The key principles of Seeking Safety are:
Safety as the overarching goal (helping clients attain safety in their relationships, thinking, behavior, and emotions)Integrated treatment (working on both PTSD and substance abuse at the same time)A focus on ideals to counteract the loss of ideals in both PTSD and substance abuseFour content areas: cognitive, behavioral, interpersonal, case managementAttention to clinician processes (helping clinicians work on countertransference, self-care, and other issues)
The treatment has shown positive results in seven studies completed so far. Each study is described on the Seeking Safety web site: http://www.seekingsafety.org/, including citations and e-mail links for ordering journal articles. Populations and settings for the studies described on the web site include substance-dependent men and women with PTSD in outpatient treatment; incarcerated women, low-income urban women, and adolescent girls with substance-use disorders and PTSD; women in an outpatient dual-diagnosis treatment program at a community mental health center; and men and women veterans in a variety of settings (i.e., an opiate treatment program and mental health and substance abuse settings).
NIDA's National Drug Abuse Treatment Clinical Trials Network (CTN) included a study of Seeking Safety that found that substance use outcomes were not significantly different over time between women receiving the Seeking Safety intevention and those received a treatment-as-usual intervention called "Women's Health Education" (Hien et al, 2009). See Protocol CTN-0015, Women's Treatment for Trauma for more information.