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 Web page.
See also the author's self-help guide Finding Your Best Self, Revised Edition: Recovery from Addiction, Trauma, or Both, an ideal client recommendation.
About the Author
Lisa M. Najavits, PhD, is currently Adjunct Professor at the University of Massachusetts Medical School and previously was on faculty at Harvard Medical School for 25 years and Boston University School of Medicine and the Veterans Affairs Boston Healthcare System for 12 years. She is author of over 180 publications, including the books Seeking Safety: A Treatment Manual for PTSD and Substance Abuse (for mental health professionals) and Finding Your Best Self, Revised Edition: Recovery from Addiction, Trauma, or Both (for general readers). She is Director of Treatment Innovations, which conducts research and training related to mental health and addiction. Dr. Najavits serves on the boards of numerous journals, including the Journal of Traumatic Stress, Journal of Gambling Studies,Journal of Dual Diagnosis, and Psychological Trauma, and has received awards including the Betty Ford Award from the Association for Medical Education and Research in Substance Abuse, the Emerging Leadership Award from the Committee on Women in Psychology of the American Psychological Association, the Early Career Contribution Award from the Society for Psychotherapy Research, and the Young Professional Award from the International Society for Traumatic Stress Studies. She also served as president of the Society of Addiction Psychology of the American Psychological Association. Her major clinical and research interests include addiction, trauma, co-occurring disorders, community-based care, veterans' mental health, development of new counseling models, and clinical trials research. She has a private psychotherapy practice in Massachusetts.
"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 strength of this manual is its comprehensiveness. The book reveals the author's extensive clinical experience working with this population and her keen ability to apply the basic principles of cognitive-behavioral and interpersonal therapies in ways that are concrete and practical....fills a long-standing gap in the assessment and treatment of PTSD and substance abuse. Najavits' thoroughness and her commitment to ongoing research in this area are illustrated by her inclusion of a questionnaire for patients and therapists who use the manual to provide input about what worked and what didn't. Psychologists, psychiatrists, social workers, and any clinicians who conduct therapy with this population will benefit from owning this manual."
— Psychiatric Services
"A highly impressive volume describing the first treatment for this population that has had published empirical validation....Essentially, what Dr. Najavits provides is a comprehensive buffet of skill-based therapy topics with accompanying handouts. From the 26 topics presented, the therapist can then select which issues are most relevant to a particular client or group of clients....The handouts provided are clear, and generally user friendly both to clinicians and clients. There is a fair amount of structure to the treatment, yet the author continually encourages clinicians to tailor the treatment to their personal style and the constraints of a clinical situation (i.e., time, setting). She is very clear on what is a 'must' in the treatment (and why) and what is a guideline. This gives the clinician the structure of a manual as well as the freedom to be a flexible, creative clinician....This treatment manual is an impressive contribution to both substance abuse and PTSD fields, as well as the target comorbid diagnostic arena. It is highly recommended for all clinicians."
— Journal of Cognitive Psychotherapy
"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!"
— Journal of Trauma Practice
"Given the prevalence of patients with both post-traumatic stress disorder (PTSD) and substance abuse diagnoses and their complex interactions, this volume makes an important and timely contribution."
— Psychotherapy Research
"Fills a tremendous gap in treatment resources....Provides clinicians with an empirically based and well-developed treatment program that enables them to intervene in comorbid SUD and PTSD in an integrated way....Provides a breath of fresh air by rising above the often contentious debate on whether cognitive behavioral therapy (CBT), psychodynamic interventions, or 12-step-oriented approaches are the best treatment model....The manual is well organized, easy to use, and relevant to the treatment needs of individuals with comorbid PTSD and SUD. It is an innovative, flexible, and practical program that is adaptable to a variety of treatment settings. Although this manual is particularly useful for clinicians, I highly recommend it as a resource for students and researchers who seek to gain a better understanding of the treatment needs of individuals who have concomitant SUD and PTSD as well."
— Criminal Justice Review
"This manual provides a well-researched treatment approach developed specifically for the difficult-to-treat but common dual diagnosis of post traumatic stress disorder and substance abuse. The author gives much of herself, her thoughts and past experiences in the preface, including reservations that are no easy answers....the book is a very useful tool, well organized and imaginative."
— Addiction Today