TREATMENT: Seeking Safety for PTSD with Substance Use Disorder

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Brief Summary

Seeking Safety for PTSD with Substance Use Disorder

Status: Strong Research Support


Seeking Safety is a present-focused therapy to help people attain safety from trauma/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 (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. The key principles of Seeking Safety are:

  • 1) Safety as the overarching goal (helping clients attain safety in their relationships, thinking, behavior, and emotions).
  • 2) Integrated treatment (working on both PTSD and substance abuse at the same time)
  • 3) A focus on ideals to counteract the loss of ideals in both PTSD and substance abuse
  • 4) Four content areas: cognitive, behavioral, interpersonal, case management
  • 5) Attention to clinician processes (helping clinicians work on countertransference, self-care, and other issues)

Key References (in reverse chronological order)

Zlotnick C, Johnson J, Najavits LM. (2009). Randomized controlled pilot study of cognitive-behavioral therapy in a sample of incarcerated women with substance use disorder and PTSD. Behavior Therapy, 40, 325-36

Najavits LM, Gallop RJ, Weiss RD. (2006). Seeking Safety therapy for adolescent girls with PTSD and substance abuse: A randomized controlled trial. Journal of Behavioral Health Services & Research, 33, 453-463.

Morrissey, JP, Jackson, EW, Ellis, AR, Amaro, H, Brown, VB, Najavits, LM. (2005). Twelve-month outcomes of trauma-informed interventions for women with co-occurring disorders. Psychiatric Services, 56, 1213-1222.

Hien DA, Cohen LR, Litt LC, Miele GM, Capstick, C. (2004). Promising empirically supported treatments for women with comorbid PTSD and substance use disorders. American Journal of Psychiatry, 161, 1426-1432.


Clinical Resources

Najavits, LM (2009). Seeking Safety: An implementation guide. In A. Rubin & DW Springer (Eds). The Clinician's Guide to Evidence-Based Practice. Hoboken, NJ: John Wiley

Many other books, videos, and clinical resources are available for Seeking Safety.


Training Opportunities

The following link provides resources on training and consultation for Seeking Safety.

Treatment Resources

Note: The resources provided below are intended to supplement not replace foundational training in mental health treatment and evidence-based practice