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 format, lay-flat binding, and helpful reproducible therapist sheets and handouts.
See also the author's self-help guide Recovery from Trauma, Addiction, or Both: Strategies for Finding Your Best Self, an ideal client recommendation.
"This landmark volume presents a cutting-edge approach to the treatment of patients who depend on drugs to soothe the pain of PTSD. In stunning detail, Najavits shows how the same therapist can treat both conditions concurrently. Her kinder and gentler approach is a welcome change from traditional confrontational interventions. The volume is enriched by her empathy and wisdom. All therapists attempting to help these patients should have this book to guide them."--Aaron T. Beck, MD, University Professor of Psychiatry, University of Pennsylvania
"Fabulous! This treatment manual provides practical, clearly described procedures for treating an extremely difficult group of clients. The organization of the treatment is superb. From my perspective, the most important parts of a comprehensive treatment are here--attention to the client's safety, targeting substance use simultaneously with targeting PTSD, integrating ideals and values (I love the quotations!), a core of cognitive-behavioral interventions, a focus on interpersonal relationships, and attention to the needs of the therapist. Very impressive. Obviously written by an experienced clinician."--Marsha M. Linehan, PhD., University Professor of Psychology, University of Washington
"Born of experience and energized by passion, this carefully crafted and thoughtful treatment manual will guide clinicians through the tricky waters of substance abuse and PTSD treatment. Seeking Safety will help clinicians decide what to do and how to do it well. As empirically guided treatment manuals begin to emerge in greater numbers and varying quality, Najavits maintains an essential and elegant balance between a lucid map of treatment directions, on the one hand, and the complex dynamics of the clinical territory on the other. This is a very important work that I highly recommend for clinicians of every stripe."--Howard J. Shaffer, PhD, CAS, Director, Division on Addictions, Harvard Medical School
"The Seeking Safety
manual itself is designed to be clinician-friendly and provides a plethora of patient and therapist information and handouts. Each chapter proves to be easily accessible, including a summary of the session coping skill, a therapist orientation to the topic, ideas for session preparation, session content, and examples of tough cases. Also included in each coping skills chapter are patient materials. These are thoughtfully designed, adding key points, examples, alternatives and suggestions, and ideas for how to apply the material to daily life. In the protocol introduction, there is a wealth of information about PTSD and substance abuse and a section on what is not part of the treatment (focused trauma work). Therapist processes are also addressed throughout the manual with a kind eye to the difficulty of helping individuals with this dual diagnosis recover. The Seeking Safety
manual is action-oriented, information- and detail-focused and is also attentive to the emotional pain that brings people into treatment....In sum, Seeking Safety
has scientific merit, clinical wisdom, provides an excellent philosophy and protocol for the 'time- and resource-strained clinician, ' and patients like it!"-- (08/01/2003)