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What is Seeking Safety?

Written by Evolve's Behavioral Health Content Team​:

Alyson Orcena, LMFT, Melissa Vallas, MD, Shikha Verma, MD, Ellen Bloch, LCSW, Lianne Tendler, LMFT, Megan Johnston, LMFT
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Seeking Safety is a relatively modern evidence-based treatment model that treats co-occurring posttraumatic stress disorder and substance abuse. Lisa M. Najavits, Ph.D. began developing the Seeking Safety treatment model in the 1990s, with assistance from the National Institute on Drug Abuse. She published the research-based Seeking Safety treatment manual in 2002.

Substance Abuse and PTSD

PTSD and substance abuse often go hand-in-hand. After a traumatic experience, many people choose unhealthy coping mechanisms, which may include using substances to escape the pain. In fact, research has shown that exposure to trauma, especially childhood trauma, increases one’s likelihood of developing substance dependence/abuse later on in life. It also increases the chances of developing other mental health issues like depression, bipolar disorder, and schizophrenia. Traumas can include neglect or abuse, including physical, sexual, or emotional abuse. Car accidents, natural disasters, war, school shootings, terrorist attacks like 9/11 (or even exposure to media coverage of traumatic events) are examples of trauma as well.

That’s why a major part of treatment for addiction and mental health disorders is trauma-focused therapy, such as Seeking Safety. Seeking Safety helps patients recover from their traumatic past so they can regain the footing they need to move forward in life. However, unlike other trauma-focused therapies, Seeking Safety does not ask the client to delve deep into the recesses and details of the trauma. For many, this can bring up too much emotional pain. Rather, the treatment focuses on the present. It asks clients to envision what safety would currently feel like in their lives. Then, it teaches them coping skills to achieve that vision.

Practical Coping Skills

There are 25 coping skills taught in Seeking Safety. Every skill applies to both trauma and addiction simultaneously. Some categories of skills include: Setting Boundaries in Relationships, Honesty, Compassion, Healing from Anger, and Recovery Thinking. The main aim of these skills is to help patients attain safety in their relationships, thinking, behavior, and emotions.

Seeking Safety therapy occurs in an individual or group setting. Therapists may administer Seeking Safety in both residential treatment (RTC) and outpatient programs (including IOP and PHP).

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