Seeking Safety

Seeking Safety is a present-focused treatment for clients with a history of trauma and substance abuse. The treatment was designed for flexible use: group or individual format, male and female clients, and a variety of settings (e.g., outpatient, inpatient, residential). Seeking Safety focuses on coping skills and psychoeducation and has five key principles: (1) safety as the overarching goal (helping clients attain safety in their relationships, thinking, behavior, and emotions); (2) integrated treatment (working on both Post-Traumatic Stress Disorder (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, and case management; and (5) attention to clinician processes (helping clinicians work on countertransference, self-care, and other issues).

The goal of this program is to help clients move beyond trauma and substance abuse.

Multiple evaluations of the Seeking Safety program in various settings have shown positive outcomes for substance abuse/addiction, substance abuse disorder, and post-traumatic stress disorder.

Since 1992, Seeking Safety has been implemented in hundreds of clinical settings and as part of statewide initiatives in Oregon, Wyoming, Connecticut, and Hawaii. It has been implemented in programs for substance abuse, mental health, domestic violence, homelessness, women and children, and veterans and in correctional, medical, and school settings throughout Australia, Canada, Germany, Japan, the Netherlands, New Zealand, Scotland, Sweden, and the United States.

There have been many evaluations of the Seeking Safety program. Evaluations in various settings have shown positive outcomes for substance abuse/addiction, substance abuse disorder, and post-traumatic stress disorder.

One particular randomized controlled trial of 107 women assessed the severity of substance use in participants assigned to Seeking Safety, Relapse Prevention, or a usual care control condition. Compared with women in the usual care control condition, women who participated in Seeking Safety significantly reduced their substance use at the end of treatment (p < 0.001) and at the 6-month follow-up (p < 0.05). The Seeking Safety participants also showed a significant improvement on measures of trauma symptoms compared with usual care participants at the end of treatment (p < 0.01), at the 6-month follow-up (p < 0.05), and at the 9-month follow-up (p < 0.05). They also improved on measures of psychopathology from pre- to post-treatment (p < 0.01), whereas participants in the control condition worsened.