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Seeking Safety

Seeking Safety. Mark M. Lowis, LMSW President: MML Consulting, LLC. Seeking Safety. This Training is presented based upon the implementation guide developed by Lisa Najavits

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Seeking Safety

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  1. Seeking Safety Mark M. Lowis, LMSW President: MML Consulting, LLC.

  2. Seeking Safety • This Training is presented based upon the implementation guide developed by Lisa Najavits Najavits, LM (2009). Seeking Safety: An Implementation Guide. In a Rubin and DW Springer, The Clinician’s Guide to Evidence-Based Practice. Hoboken, JJ: John Wiley.

  3. Seeking Safety • The Title “Seeking Safety” is also the objective of the method • Seeking Safety is an evidence based practice designed for working with people who have co-morbid issues with regard to trauma (PTSD), substance use disorders (SUD) • The goal of Seeking Safety is to promote recovery by assisting the individual in developing strategies to keep them safe from the effects of trauma and the painful impact of substance use. • Seeking Safety is a Cognitive Behavioral method

  4. Seeking Safety • Practitioner Profile • ANY Clinician can conduct Seeking Safety • Have a desire to work with this population • Willingness to use a Manual-based approach • Positive interpersonal skills • Empathy • Respect • Genuine

  5. Seeking Safety • Present focused • Empathetic and person centered • Safety is goal for the person and practitioner • Integrated • Clearly defines the “traumatic” experiences • Clearly defines the connection of trauma to SA • Validates the connection of trauma to SA • Provides psycho-education • Safe Coping Skills • Manage Impulses • Manage Emotions

  6. Seeking Safety • Early Stage Treatment • Integrated Treatment • Teaching Coping Skills • Present-Focused • Idealistic • Evidence Based • Targeting four domains (Cognitive, Behavioral, interpersonal, case management) to target the whole person

  7. Seeking Safety • 25 Manualized Topics (clinician guide and handouts) • Engaging • Flexible • Clinician sensitive • Structured for client comfort • Public health emphasis for cost effectiveness • User friendly • Compassionate tone

  8. SeekingSafety • Practical • Relevant to different subgroups • Can be combined with other treatment • Simple engaging language

  9. Common Elements for Recovery Orientation • Developing behaviors rather than “stopping” a behaviors • Which behaviors will assist the person in recovering a critical life function • Which behaviors will ameliorate barriers to recovery • Recovery progress is a direct result of the usefulness of the assistive/collaborative alliance between practitioner and person

  10. Common Elements for Person Centered • Advanced skills for understanding and following the client • Used within an interpersonal context • Constancy is important within the personalities of the practitioner and client • Building skills for individualized issues around recovery • Exercises and activities chosen by the person with assistance and facilitation by the practitioner • Matching the interpersonal activities, exercises, and discussion with person centered levels of readiness and motivation • Increasing motivation by tying activities to critical concerns of the person

  11. Seeking Safety • 25 Treatment Topics • Introduction to Treatment and Case Management • Safety • PTSD: Taking Back Your power • Detaching from Emotional Pain • When Substances Control You • Asking for Help

  12. Seeking Safety • 25 Treatment Topic • Taking good care of yourself • Compassion • Red and Green Flags • Honesty • Recovery Thinking • Integrating the Split Self • Commitment

  13. Seeking Saftey • 25 Treatment Topics • Creating Meaning • Community Resources • Setting Boundaries in Relationships • Discovery • Getting Others to Support You • Coping with Triggers • Respecting Your Time

  14. Seeking Safety • 25 Treatment Topics • Healthy Relationship • Self Nurturing Behavior • Healing From Anger • The Life Choices Game • Termination

  15. Seeking Safety • Use of the Topics is a Facilitated, Flexible, Dynamic Activity • Not Necessary to use all 25 Topics • Topics can be used in any order • Each Topic is independent of the others • Each Topic has multiple handouts

  16. Seeking Safety • Sessions are Structured for effective use of time based on client centered considerations • Structure of Topic Sessions • Check-In to center on present condition • Quotation Read out-loud to set the tone • Handouts used to guide discussion related to the participant’s current condition • Check-Out to ground the discussion in participant’s progress and positive ending to the activity

  17. Seeking Safety • Exercises • Each Topic Exercise is arranged in the manual to support both the practitioner and the participant • Two sets of handouts are provided • Practitioner Handout to assist with facilitation of the activity • Participant Hander to assist with participation • Review the practitioner handout prior to the activity if planned. • Copy participant handouts and have them available for each group.

  18. Seeking Safety • Practitioner Skills • Be as inclusive as possible • Encourage participants to apply coping skills broadly • Use Case Management strategies to link participants to multiple resources, supports and services • Guide participants in the use of materials • Encourage participation by allowing sampling

  19. Seeking Safety • Practitioner Skills • Stage-matched facilitation • Adapt approach to participant symptoms, conditions, circumstances • Avoid arbitrary criteria • Teach participants that coping is possible in any situation • Encourage headlines not details • Redirect and contain

  20. Seeking Safety • Practitioner Skills • Watch for power dynamics • Use methods to aid in full participation • Give honest/validating feedback • Combining “past focus” and “present focused” techniques • Find out what coping skills have been used, tried or taught • Triage Approach for selecting topics

  21. Seeking Safety • Basic Group Skills • Single or co-lead • Facilitation • Name the group • Determine group size • Small=3 to 8 • Medium=9 to 15 • Large=16 plus • Rules and Structure

  22. Seeking Safety • EXERCISE • Set Up • Facilitate Discussion Using Topic Provided

  23. References • Treating Complex Traumatic Stress Disorders: An Evidence Based Guide, (edited by Christine A. Courtois; Julian D. Ford) Guilford Press, 2009. • Najavits, LM (2009). Seeking Safety: An Implementation Guide. In A. Rubin and DW Springer, the Guide to Evidence Based Practice. Hoboken NJ: John Wiley. • Najavits, LM. Seeking Safety: A Treatment Manual for PTSD and Substance Abuse, Guilford Press, 2002

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