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Introducing Seeking Safety: An Evidenced Based Therapy for Co-Occurring Post Traumatic Stress Disorder (PTSD) and Substance Use Disorders (SUDs)

Malvern Treatment Center (MTC) offers evidenced-based therapy for co-occurring Post Traumatic Stress Disorder (PTSD) and substance use disorders (SUDs) across each of our three residential rehabs.

Researchers and clinicians recommend an integrated way of treating PTSD and SUDs because it’s more sensitive to people’s needs and more likely to succeed (versus treating each separately). Our clients agree.

Based on twice-weekly feedback from group members about the benefits of focusing on safety first and always, MTC continues to provide clients the option of attending Seeking Safety groups up to twice weekly (Najavits, 2002).

What is the Seeking Safety Treatment?

Seeking Safety is an effective and well-established treatment, actually the first of its kind, and provides our clients a means to start to establish safe ways of managing thoughts, emotions, bodily feelings, and actions related to the impact of substance use and often complex traumas.

Groups for both men and women run every week, and are led by clinicians with expertise in psychology, trauma and grief, chronic and persistent mental illness, and substance use disorders.

How Does the Seeking Safety Treatment Work?

Seeking Safety is an adaptation of Cognitive Behavioral Therapy (CBT) with 25 topics integrating cognitive, interpersonal, behavioral, and case management domains. It is a flexible treatment that can be (and is) used individually and in group settings at MTC.

It is not a “cookbook” but rather requires that the therapist display clinical acumen and expert ability to listen very well and adapt. The bottom line is that any particular Seeking Safety topic must be made relevant to the group members’ lives, and to that end our therapists listen and guide and adapt to the group members’ needs, not the other way around.

Benefits from the treatment:

  • The group helped them learn that they’ve been living with undiagnosed PTSD
  • They learned skills to temporarily distract (i.e. “ground”) themselves to prevent impulsive decision making
  • They learned to act more compassionately towards themselves
  • They identified ways they have made unsafe choices while learning ways to start to make safer choices

While eventually sharing one’s trauma narrative is often an important part of treating trauma, it is explicitly not a part of Seeking Safety which is essentially step one in treating trauma and SUDs, that is, establishing safety of action, thought, sensations, and emotions.

If our clients disclose too much, too soon, without the ability to effectively regulate thoughts, emotions, physiology, and actions, they could be at greater risk of leaving treatment early and relapsing.

We know from best practices in treating co-occurring disorders that the quicker the engagement, the more likely one is to stay in treatment, and that the longer one stays in treatment, the greater the likelihood of recovery. People come to us because they often are not behaving safely. Seeking Safety is one of the many ways we help people learn to do so.

The 5 Guiding Principles of Seeking Safety

  1. Safety as the goal, above all
  2. Integrating both disorders – we help people learn what the two disorders are and why/how they co-occur
  3. Focusing on ideals – both disorders can lead to a person losing their values. Seeking Safety helps people begin to restore them. If we’re asking people to give up drugs, we had better be offering them something of higher value to replace it.
  4. Focusing on cognitive, behavioral, interpersonal, and case management domains helps address the multiple ways that these two disorders negatively impact people’s lives.

Attention to the therapist’s processes, which we believe are particularly necessary when working with people recovering from substance use disorders

Common topics offered include:

  • Learning ways to effectively distract from very high emotional pain that might otherwise lead to leaving treatment and relapsing
  • Learning what PTSD is and how it and SUDs mutually impact and exacerbate each other
  • Learning the skill of asking for help
  • Identifying healthful and unhealthful relationships
  • How to cope safely
  • Identifying triggers
  • Learning to respond with realistic self-compassion versus harsh self-criticism

Takeaway: Why Choose Seeking Safety?

We listen to our clients’ feedback, and they have told us time and again how helpful Seeking Safety is for them, and how grateful they are to have validation for the complexity and particular challenges they face with co-occurring PTSD and SUDs.

They also have given us honest feedback, which we ask for in each group, which has helped us improve our groups in the service of the people we serve. These are the reasons we continue to offer Seeking Safety and why we included it in our programming across all three sites, including our newest site in South Philadelphia.

Looking for more information about Seeking Safety? Visit Seeking Safety’s website to learn more about how Seeking Safety can help those struggling with co-occurring PTSD and Substance Use Disorders.

Author: George Collins Psy.D, MBA

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