A seeking safety therapy program is an evidence-based treatment that is designed to increase safety in individuals who have experienced trauma and/or substance abuse. The primary goal of the seeking safety model is to assist participants in attaining safety in their relationships, thinking, behavior, and emotions.
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What Is Seeking Safety Therapy?
Seeking safety therapy was developed in 1992 by Lisa Najavits to address trauma and substance abuse simultaneously, without requiring individuals to explore their trauma narrative directly (accessing detailed and disturbing memories). Though seeking safety is trauma-focused therapy, clients do not need to have a formal diagnosis of post-traumatic stress disorder (PTSD) or substance abuse to benefit from this therapeutic model, as the primary goal of a seeking safety therapy program is to increase safe coping skills relevant to both concerns.
This safety program can be utilized in a group or individual context and is extremely successful in both settings. In a group setting, patients are encouraged to share what they feel is appropriate and provide encouragement and feedback to one another as they learn to increase seeking safety coping skills together.
Group members are then encouraged to discuss what may have come up during the group treatment sessions during their individual therapy to further explore themes and difficulties or practice coping skills. In an individual session, clients are able to spend more time exploring their unsafe behavior and practice their new coping skills at length as well as have the opportunity to move at a pace best suited to their individual needs.
When an individual has experienced a single or repeated experience of sexual, physical, or mental abuse or has experienced post-traumatic symptoms following a loss, they may experience guilt, anger, feelings of helplessness, anxiety, or depression. In addition to the emotional responses, someone might also experience sleep issues, difficulty concentrating, reoccurring thoughts or nightmares about the event, or severe emotional responses to what others might experience as neutral, ordinary events.
Trauma-focused therapy typically utilizes cognitive behavioral therapy techniques to help shift harmful thought patterns related to the trauma to healthy, productive thinking and behavior. This therapy model utilizes this technique while building self-compassion as clients learn and practice seeking safety coping skills to manage emotional reactions they may be experiencing.
In a trauma-focused therapy model, the primary focus is an individual’s safety and understanding that what may currently be seen as maladaptive behavior was, at one time, a protective or safer feeling than the trauma that occurred. With this underlying belief, clients are gently guided to identify safe, healthy ways to manage the symptoms experienced as a result of trauma so that they are ultimately able to heal.
Seeking Safety Coping Skills
The primary focus of a seeking safety therapy program in San Diego is to increase safe coping skills. Coping skills are the behaviors a person engages in, in order to tolerate discomfort, pain, anxiety, depression, etc. Many individuals who have experienced traumatic life events have responded to their discomfort in unsafe ways, such as abusing substances, engaging in unsafe physical self-harming behavior, or engaging in unsafe relationships. A seeking safety therapy program introduces new options to begin to tolerate the discomfort and begin thinking about ways to distance oneself in a healthy way from the discomfort.
Individuals are introduced to coping skills, including grounding techniques, self-help groups, and the importance of a safe community, utilizing safe, supportive individuals, understanding the recovery process, understanding self-care, identifying triggers, creating healing meanings, setting boundaries, getting “un-stuck” and creating a relapse prevention plan.
In both group and individual therapies, individuals are encouraged to practice the coping skills learned and begin to implement the new skills with the support of a therapist. Introducing and learning new coping skills in a group context also offers the support and feedback of others to expand an individual’s own experience and increase connection with others.
PTSD and Substance Abuse
Research shows that individuals who have experienced PTSD are significantly more likely to engage in problematic substance use. Najavits documents that 80% of individuals who suffer from PTSD also struggle with substance abuse. Several links between post-traumatic stress disorder and substance abuse exist, which makes addressing both simultaneously very important.
In both PTSD and substance abuse, individuals may experience the need for secrecy and a loss of control. Individuals may experience shame regarding trauma experienced or substances used and wish to keep the problem quiet for fear of judgment. Individuals may also experience a feeling of loss of control related to the inability to control substance use or related to a particular event or series of events one had no control over.
In increasing safety, individuals gain greater control over their substance use disorders and the intrusive symptoms of PTSD. Individuals also gain greater self-compassion as they build an understanding that they reduce shame by decreasing the secrecy of the issues they are facing because shame can only exist when secrets hold one hostage.
The Seeking Safety Model
A seeking safety therapy program provides a structured session in both group and individual sessions. Each session includes a check-in assessing the client’s current state and unsafe behaviors/good coping that were experienced between sessions and a review of community resources utilized. Individuals are then presented with a quote relevant to the session topic. The session progresses into one of 25 topics, each of which is a coping skill applicable to trauma and substance abuse.
The content of each session is categorized as either cognitive, behavioral, interpersonal, or case management. Individuals are provided with relevant worksheets and handouts about the topic presented and are encouraged to discuss and process that particular topic. Clients are asked to check out at the close of each session and commit for the upcoming week or time between sessions.
If community resources are needed, these are made available at the close of the session. Therapists utilizing the seeking safety model assess which topics are most relevant to the individual or group needs and may utilize all or some of the topics for positive outcomes. The therapist facilitating the seeking safety model may also extend topics over several sessions if needed, as the structure is meant to be flexible and dependent on the needs of those participating.
Seeking safety therapy programs have been endorsed by numerous professional societies as having strong empirical support for PTSD/substance abuse. They continue to be studied as applications for these models grow.