Seeking safety A treatment Manual for PTSD and Substance Abuse

by Lisa M. Najavits

This manual presents the first empirically studied, integrative treatment approach developed specifically for co-occurring PTSD and substance abuse. For persons with this prevalent and difficult-to-treat dual diagnosis, the most urgent clinical need is to establish safety--to work toward discontinuing substance use, letting go of dangerous relationships, and gaining control over such extreme symptoms as dissociation and self-harm. The manual is divided into 25 specific units or topics, addressing a range of different cognitive, behavioral, and interpersonal domains. Each topic provides highly practical tools and techniques to engage patients in treatment; teach "safe coping skills" that apply to both disorders; and restore ideals that have been lost, including respect, care, protection, and healing. Structured yet flexible, topics can be conducted in any order and in a range of different formats and settings. The volume is designed for maximum ease of use with a large-size format and helpful reproducible therapist sheets and handouts, which purchasers can also download and print at the companion webpage.

See also the author's self-help guide Finding Your Best Self, Revised Edition: Recovery from Addiction, Trauma, or Both , an ideal client recommendation.

Genres: Psychology, Mental Health, Nonfiction, Counselling, Social Work, Reference

401 pages, Paperback

First published December 14, 2001

Reviews

[Joelle · Rating 5 out of 5]

This is one of the most user-friendly treatment manuals I have run across. The sessions are stand-alone and can be done either in a group or individual format. Lots of good information for clinicians to take into account before working through a session with a client. I use this with teen girls I work with at a correctional facility. They seem to get a lot out of it. Really, a great resource!

[Cara · Rating 4 out of 5]

User-friendly and informative. My main criticism is that the book has not been updated since 2002. Another suggestion for improvement is to make the handouts available online or in PDF form to book purchasers.

[Nikki Morse · Rating 4 out of 5]

Seeking safety is a cognitive, behavioral and interpersonal model for addressing ptsd and substance use together. I'm using this model at my internship, and finding it very useful. We have adapted it somewhat and find it amenable to those shifts while also providing a clear map. My only critique is that there is a list of "problem cases" at the end of each chapter, and then no discussion about how to deal with them!

[Noel · Rating 5 out of 5]

Love this manual! Informative and relevant. Whereas other PTSD/SUD curriculums feel lacking in either substance and/or execution, this one feels fully fleshed out. I agree with other reviewers stating that an updated version would be beneficial. And, yes, it would be extremely appreciated if that hypothetical update included online resources and PDF handouts.

[James Atkison · Rating 5 out of 5]

Very useful therapy manual.

[Hester Rathbone · Rating 5 out of 5]

I'm a little in love with this book. This happens any time I find a new book that has great activities and lessons for me to share with my clients and other clinicians.
I think that this is the most comprehensive guide I've ever read on the co-morbidity that often exists between PTSD and Substance Abuse. The author, Miss Davits, worked hard to incorporate a lot of excellent interventions. Her sections on grounding and coping skills are particularly well-written. I also love the way she dispels a lot of the myths that still exist in this line of work - such as the idea that you can only manage substance abuse and PTSD independently of one another. When clinicians try to do that, they're actually just taking away the one coping skill most of their clients have found that works at providing some relief. These things need to be accepted and worked on together, rather than ignoring the needs of one to try to resolve the other. I also love what she has to say about anger and how a lot of the old-fashioned strategies - screaming into a pillow, throwing rocks at a tree - can actually heighten the feelings of anger instead of de-escalating them. Anger can be constructive rather than destructive, as long as the therapist actually addresses it (instead of prettying everything up or ignoring it) and helps the client to understand what their anger is telling them.

[Victoria Moore · Rating 5 out of 5]

This is an excellent book to either read on your own or while in therapy if you are suffering from Post-Traumatic Stress Disorder (PTSD) or Substance Abuse because it gives you excellent tips on how to deal with various triggers and issues. The sections I learned the most from were the treatment ones (i.e., "PTSD Taking Back Your Power," "Taking Good Care of Yourself," etc.,) because they had instructions on what to do if you encountered obstacles that previously halted your progress towards a functioning life. In addition to inspiring quotes the author also included real anecdotes from patients who bravely shared their stories and resource numbers and websites for those who needed help from Community Organizations.

[Collin Reeve · Rating 5 out of 5]

For all the advances that have been made in trauma informed care over the last few years seeking safety is still one of the most well thought out approaches to working with clients suffering from trauma and substance use disorders. It's easy to implement and can be easily adapted to the population you work with. I think the field of trauma informed care owes a lot to Dr. Najavits a lot of credit for her advances in our work.

[Chrissie · Rating 5 out of 5]

Excellent resource - very applicable to other population's!

[Jill · Rating 5 out of 5]

Excellent, pragmatic, compassionate approach. Applying this to all of my work.