Seeking Safety: A Psychotherapy for PTSD and Addiction

What is Seeking Safety? 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.

It was begun in 1992, under grant funding from the National Institute on Drug Abuse. It was developed by Lisa M. Najavits, PhD at Harvard Medical School/McLean Hospital.

Introduction/Case Management, Safety, PTSD: Taking Back Your Power, When Substances Control You, Honesty, Asking for Help, Setting Boundaries in Relationships, Getting Others to Support Your Recovery, Healthy Relationships, Community Resources, Compassion, , Creating Meaning, Discovery, Integrating the Split Self, Recovery Thinking, Taking Good Care of Yourself, Commitment, Respecting Your Time, Coping with Triggers, Self-Nurturing, Red and Green Flags, Detaching from Emotional Pain (Grounding). Life Choices, and Termination. For a brief description of all topics, click here.

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)

"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....All therapists attempting to help these patients should have this book to guide them."
-Aaron T. Beck, MD, 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 Linehan, PhD, University of Washington

"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, Harvard Medical School

The treatment manual is published as a book titled, Seeking Safety: A Treatment Manual for PTSD and Substance Abuse (Guilford Press, New York, 2002). It is 401 pages, and provides client handouts for use in sessions and clinician guidelines for conducting the treatment. To order it, click on the book picture here, or the links below. The list price is $38, but discounts are often available.

Note: The client handouts can be xeroxed for personal use in unlimited fashion (e.g., the clinician can copy them for any number of clients). However, for reproducing the handouts in any published electronic or written form or for any use other than one's own clinical practice, permission is needed from Guilford Press.

The book can also be ordered from the publisher, Guilford Press (800-365-7006, extension 223). Discounts are sometimes available at the websites above (Amazon and Barnes and Noble), and are available from Guilford Press for multiple books. Also, Guilford can send books on a consignment basis ( an organization can order books for a conference or other purpose, and if some books are not sold, ship them back to Guilford for full refund). For for multiple copies or the consignment process, contact Guilford ( Daniel Cocozza: 800-365-7006 extension 223, or by email daniel.cocozza@guilford.com).

If you are interested in adapting Seeking Safety or reprinting parts of it (beyond personal use), please note the following. If you plan to publish, research, or broadly distribute an adapted version of Seeking Safety, or parts of it (e.g., certain handouts), you will need to obtain permission from Guilford Press in advance as they own the copyright to the material. You can contact Guilford Press (800-365-7006, extension 245), or you can go directly to their page (www.guilford.com, click "permissions"). If you would like Lisa Najavits' assistance in adapting it, please contact her.

A set of training videos on Seeking Safety is now available. They were developed under a grant from the National Institute on Drug Abuse. The videos are as follows:

1. Seeking Safety. A 2-hour training video by Lisa Najavits, and including clips from real clients and clinicians.

2. A Client's Story. A 20-minute video in which a man describes the impact of sexual abuse and addiction, and his attempts to obtain treatment.

3. Example of Teaching Grounding to a Client. A 16-minute example of teaching a real client the skill of "grounding" using the script from the Seeking Safety manual.

4. Therapy Session: Asking for Help. A 1-hour video of Lisa Najavits conducting a group session with real clients.

5. Adherence Rating Session: Healthy Relationships. A 1-hour video of a clinician conducting a group session with real clients. This session was designed to show both good and poor elements, and is for use with the Seeking Safety Adherence Scale.

If you would like to be added to a list to receive information on it, please email info@seekingsafety.org and just note "multimedia" in the subject line or the email itself.

Plans are underway to translate the Seeking Safety book into Spanish. Expected date is early January 2005, and it will be available as "print on demand" (i.e., it will look just like the English version and be a regular bound book, available by order from this website). If you would like to be added to a list to receive information on it when it is completed, please email info@seekingsafety.org and just note "spanish" in the subject line or the email itself.

The following are clinicians who have emailed to be added to this list as currently conducting Seeking Safety and accepting client referrals. Please note that these are self-listings and not an endorsement of particular programs or clinicians; nor are these trainers in Seeking Safety. If you are a clinician or program and would like to be added to this list, please contact Lisa with the details, and it will be added here.

Brookline, MA: Kay M. Johnson, LICSW; group and individual Seeking Safety; private practice with sliding scale. 617-731-1500 kmjcsw@aolcom [posted 12/6/05]

Hamden, CT: Trauma and Substance Abuse Therapy for Women. Contact Gilberte Najamy, MS 203-288-0210 gilberte411@sbcglobal.net [Posted 9/27/05]

Bridgeport, CT: The Center for Women and Families. Contact Margaret Weeks, MSW at 203-334-6154 x45 or mweeks@cwfefc.org

Belmont, MA: McLean Hospital (outpatient Seeking Safety group for women, on-going, led by Terri Levine, LICSW). Contact her at 617-855-3796. There is currently space available in this group. [Posted 2005]

Fall River, MA: Stanley Street Treatment and Resources (SSTAR) (outpatient Seeking Safety group for women Tuesdays from 10:30 - 12:00, led by Flinda Behringer, LICSW). To join, make an appointment for a general intake at SSTAR by calling 508-679-5222 [Posted 2005]

Cape Cod, MA: Gosnald Treatment Center (Seeking Safety groups offered at outpatient sites in Falmouth, Pocasset and Centerville); Contact Michele Carty: 508-563-2262 X418 [Posted 2005]

Midtown Manhattan, NY (groups Saturday afternoons and Sunday mornings); Contact Jennifer Highley-Wheeler, M.S., N.P.; 917-415-1953 or highleywheeler@mac.com (sliding scale; does not accept insurance but will give receipt that can be submitted to insurance company). [Posted 2005]

Tampa, FL: HealthCare Connection of Tampa (group for women, and some individual treatment); contact John Harden, LCSW, CAP, MPH, 800-444-4434 or 813-931-5560 www.healthcareconnectionoftampa.com

Chapel Hill, North Carolina: OPC Area Program-Northside Clinic (Outpatient Seeking Safety group for women; 12 weeks closed group, Wednesdays 4-6 p.m. Must be Orange County resident to qualify. Led by Susanne Kaiser, MA, LPC. Contact her at 919- 913-4200. [Posted 2005]

Alexandria, VA: private practice; contact Denise Tordella, MA, LPC, dutordella@aol.com 703 517-6379 [Posted 9/27/05]

Los Angeles, CA: PROTOTYPES Women's Center (multiple levels of care), at 845 E. Arrow Hwy in Pomona. Contact Elke Rechberger, PhD 909-624-1233 x161 [Posted 7/05]

Anaheim, CA and Huntington Beach, CA (group treatment); one is at 1st Baptist Church in Anaheim, CA and the other at Redeemer Lutheran in Huntington Beach, CA. Does not take insurance, but will provide a receipt for reinbursement by the client's insurance company. This is a professional Christian Counseling agency and so prayer and Scripture will be integrated into the group format. Contact Darlene Lemmo (licensed marriage and family therapist) dlemmo@socal.rr.com [Posted 9/27/05]

Sometimes it can be helpful to connect with others using the model. Here are some people who have agreed to be contacted for this purpose. However, please note that this list solely reflects people who have emailed to be listed here-- they have not necessarily been trained in the model, they are not associates of Lisa Najavits to provide the standard training in Seeking Safety (see Training), nor has their clinical implementation been reviewed in any way. This is just intended as an informal, helpful resource. If any questions or concerns, contact Lisa.

(1) Elke Rechberger, PhD 909-624-1233 x161 (has conducted SS for several years at PROTOTYPES Women's Center in Los Angeles, which offers multiple levels of care)

(2) Ann E. Burke, LCSW (has conducted SS for 2 years as of 6/05); Sr. Mental Health Counselor; CalWORKs Clinical Team; Sacramento County DHHS; Mental Health Division; 9136 Elk Grove Blvd., Elk Grove, CA 95624; (916) 686-5017; burkeann@saccounty.net

If you would like to be added to the list above, please contact Lisa with any information about your work that you would like to provide (whether you accept referrals and if so, whether for group or individual Seeking Safety sessions, insurance or other practical information, how long you have conducted Seeking Safety, research interests related to it, etc.). Thanks for your interest!

Lisa M. Najavits, PhD is Associate Clinical Professor in the Department of Psychiatry, Harvard Medical School (Boston, MA); director of the Trauma Research Program in the Alcohol and Drug Abuse Treatment Center at McLean Hospital (Belmont, MA), and research psychologist at the National Center for PTSD, VA Boston Healthcare System. She is author of the books Seeking Safety: A Treatment Manual for PTSD and Substance Abuse (2002) and A Woman’s Addiction Workbook (New Harbinger Press; 2002), as well as over 90 professional publications. In 1997 she was recipient of the Chaim Danieli Young Professional Award of the International Society for Traumatic Stress Studies, in 1998 the Early Career Award of the Society for Psychotherapy Research, and in 2004 the Emerging Leadership Award of the American Psychological Association's Committee on Women. She is past-president of the New England Society for Behavior Analysis and Therapy; and on the advisory boards of Psychotherapy Research, the Journal of Traumatic Stress, and the Journal of Gambling Studies. Dr. Najavits has received a variety of National Institutes of Health research grants, including an Independent Scientist Career Award from the National Institute on Drug Abuse . She is a licensed psychologist in Massachusetts; a psychotherapy supervisor; and conducts a psychotherapy practice. She received her PhD in clinical psychology from Vanderbilt University (Nashville, Tennessee) and her bachelor’s degree with honors from Columbia University (New York, New York). Her major clinical and research interests include: trauma, posttraumatic stress disorder; substance abuse; and psychotherapy outcome research. For more detailed information, you can download Lisa's biosketch (2 pages) or c.v. (21 pages).