Seeking Safety Therapy: A Path to Healing Trauma

Introduction

Seeking safety therapy is a relatively modern treatment, developed by Lisa Najavits in 1992. It is an evidence-based therapy, and is mainly geared toward increasing the safety of those persons who have experienced trauma and substance use disorder in their lives.

The goal of seeking safety therapy is to facilitate clients in their journey toward safety in thinking, emotional, behavioral, and relationship patterns.

At NuView, we build on the seeking safety model to facilitate clients who experience trauma or substance use disorder toward safety and healing in their lives.

What is Seeking Safety Therapy?

Past traumatic events or Post-Traumatic Stress Disorder (PTSD) can affect many if not all aspects of a person’s life. Usually, people may even turn to substance use to numb or escape from their suffering. Seeking safety therapy is an evidence-based therapy to address these conditions, especially as substance use disorders are highly comorbid with trauma or PTSD.

While seeking safety therapy is a trauma-focused therapy, it does not require a formal diagnosis of either trauma, PTSD, or substance use disorder for treatment. It treats and equips a person with healthy coping skills. In one-on-one or group sessions, the therapist and clients explore unsafe behaviors and find ways to practice coping skills. In fact, in group sessions, clients are provided with a safe space where they can share experiences, encourage one another, and learn coping skills together.

Learn more about the Relationship between Stress and Substance Use Disorders.

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The Core Principles of Seeking Safety Therapy

Seeking safety therapy has been an evidence-based practice for more than 30 years now. It is mainly used to treat the generally co-occurring mental health conditions of trauma/PTSD and substance use disorder. It is based on five core principles:

• Safety is the priority of the therapy.

• The aim of the therapy is to integrate the treatment of both trauma and substance use disorders.

• The therapy seeks to inspire hope as the way to recovery.

• The therapy addresses the cognitive, behavioral, and interpersonal aspects of life.

• The therapy focuses on building coping skills, and there are 25 coping skills integrated into the seeking safety model.

How Seeking Safety Helps People with Trauma and Addiction?

The seeking safety model recognizes that trauma and substance use disorders are not necessarily distinct from one another. They are, in fact, comorbid. Seeking safety therapy helps clients by addressing both of these conditions together.

Next, seeking safety therapy integrates different practices, like mindfulness meditation, to cope with trauma. It is all about living in the present moment rather than reliving the past over and over again. It is something very much unlike other trauma-focused therapies, as its intention is to avoid ruminating over the past or thinking negatively about the future.

Seeking safety therapy empowers its clients not with just a few coping skills, but with 25 tried and tested coping skills. These coping skills help clients not fall into unhealthy patterns like substance use. They include honesty, self-compassion, strengthening interpersonal relationships, setting boundaries within relationships, instilling recovery thinking, and more.

Seeking safety therapy identifies the client’s subjective emotional experience of trauma, and this can even apply to vicarious trauma. Vicarious trauma is watching or listening to others’ experiences of trauma. It also believes that there is recovery from trauma and a path forward. While coping with trauma is essential, the seeking safety therapy understands that coping can lead to unhealthy coping patterns like substance use. With the right approach, self-help strategies, and support, recovery from trauma as well as substance use is achievable.

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Key Topics Covered in Seeking Safety Sessions

Seeking safety therapy sessions cover 25 topics as a whole. These explore cognitive, emotional, behavioral, and relationship patterns in life.

1. Introduction – An introduction to seeking safety treatment is provided. This phase also includes getting to know the client and case management.
2. Safety – Safety is the key focus of seeking safety treatment. It is the first stage of healing from trauma and substance use.
3. Taking Back Power – It involves psycho-education, which is equipping the client with information regarding trauma and substance use.
4. Grounding – This is basically detaching from the emotional pain of trauma, albeit in a healthy manner. It involves physical, mental, and soothing exercises.
5. When Substance Use Takes Control – Eight handouts are provided, which are meant to educate the client on how substances can take control of their life. These can be combined with the therapy and also used separately.
6. Help-Seeking Behavior – Trauma and substance use require social support to heal from. It makes the client aware of this and also promotes help-seeking behavior as important and not weak.
7. Self-Care – The therapy instills self-care behaviors in the client and also understands how well they take care of themselves. If any aspect of self-care is left unfulfilled, immediate action is taken to address the same.
8. Self-Compassion – Trauma and substance use can make a client frustrated with themselves. However, the therapy helps them approach these factors with a sense of compassion and understanding.
9. Red and Green Flags – Trauma and substance use recovery is not a straight path, it is non-linear with its ups and downs. Red and green flags refer to the signs of danger and safety, and they are identified to create a safety plan on how to deal with the client’s mild to severe red flags.
10. Honesty – The client is encouraged to be honest with their trauma and substance use experiences, and this is instilled with the help of role-playing exercises.
11. Recovery Thinking – Generally, the kind of thinking associated with trauma and substance use is negative. However, with recovery thinking, a more optimistic view of the path forward is instilled. The client is given rethinking tools to engage in recovery thinking, which involves listing healthy options, making decisions, and more.
12. Integrating the Split Self – Splitting is often a defense mechanism used in cases of trauma and substance use. First, the client is guided toward identifying the split nature of their self, for instance, the side of the self that is either ambivalent or in denial of trauma and substance use. Then, efforts are made to integrate the split self to overcome these behaviors.

13. Commitment – The client is made to understand that keeping promises to oneself and others is important. Strategies for increasing commitment are then implemented. 

14. Creating Meaning – The client’s meaning of trauma and substance use is discussed, and harmful meanings are contrasted with meanings of healing and recovery.
15. Community Resources – A sense of community and belonging are useful in healing, and a list of community resources like self-help, newsletters, and advocacy organizations are provided to the client.
16. Setting Boundaries in Interpersonal Relationships – In interpersonal relationships, boundary lines become very blurry or do not exist at all. However, healthy relationships require boundaries, and the same are described to the client. This is especially important in cases of abuse and interpersonal violence.
17. Discovery – A rigid mindset develops with regard to trauma and substance use. Discovery is a tool that seeks to combat this rigidity and allows the client to be open to new knowledge and experiences.
18. Getting Others to Support Recovery – Social support is highly essential for recovering from trauma and substance use. The client is encouraged to identify those in their life who are supportive, neutral, or negative to their recovery. Based on this, the client is made to promote the understanding of trauma and substance use in their social circles to find support for their recovery. Supportive family members or friends can also attend this session with the client.
19. Coping With Triggers – Triggers are categorized into who, what, and where. By changing who the client is with, what they do, and where they are, they can cope with triggers of trauma and substance use.
20. Respecting Time – The client is made to understand the time they have lost and how to make the best of their time and future going forward with recovery.
21. Healthy Relationships – The client identifies how trauma and substance use can lead to unhealthy relationship patterns. By learning skills on how to create good relationships in life, they can journey toward positive relationships in life.
22. Self-Nurturing – Recovery from trauma requires self-nurturing. However, safe self-nurturing is contrasted with unsafe self-nurturing (like substance use), and then, safe self-nurturing methods are enhanced.
23. Healing From Anger – Anger can be both helpful and unhelpful in recovery from trauma and substance use. Information regarding how to best work with both these types of anger is provided to the client.
24. Life Choices – This is a game, and is a part of the termination process. The client is provided with some unsettling circumstances and is required to respond with how they will cope with such circumstances. With this game, healthy coping skills are targeted.
25. Termination – The client identifies the things they liked and disliked about the therapy, and an aftercare plan is also finalized during the termination phase. 

Who Can Benefit from Seeking Safety Therapy?

Seeking safety therapy is an evidence-based practice, geared toward people experiencing co-occurring conditions of trauma/PTSD and substance use.

Seeking safety therapy equips clients with coping skills to break away from the cycles of destructive, dependent behaviors that are usually associated with trauma, PTSD, and substance use. The therapy helps clients toward recovery and build a healthy, fulfilling future.

Seeking Safety Therapy vs. Traditional Trauma Therapy

Seeking safety therapy and traditional trauma therapy are both trauma-focused therapies. They seek to heal clients from trauma and move toward healing. However, there are a few differences between the two.

Seeking safety therapy does not require a formal diagnosis of trauma, PTSD, or substance use. It is focused on the present and avoids going over the past when it comes to trauma, which is a boon for clients who are frightened of confronting their trauma. Instead, it focuses on how trauma and substance use are presently affecting a person’s life with tools like mindfulness meditation and seeks to heal from the same. Seeking safety therapy works by equipping clients with coping skills like empowerment, healthy boundaries, and other transformative tools related to managing emotions and behaviors.

Meanwhile, traditional trauma therapy involves a deeper exploration of past trauma. It involves techniques like prolonged exposure, cognitive processing therapy, and eye movement desensitization reprocessing. These techniques aim to process and reframe traumatic experiences in an effort to change how clients respond to triggers as well as traumatic experiences. Traditional trauma therapy is more intensive.  

What to Expect in a Seeking Safety Therapy Session?

At the NuView Treatment Center, our medical and clinical team provides structured individual and group seeking safety therapy sessions.

Every session will delve into clients’ present states of mind and any unsafe behavioral patterns engaged in between sessions. Then, the session dives into 1 of the 25 key topics of the seeking safety model. The session begins with a quote relevant to the topic.

The content of the session is categorized as either cognitive, behavioral, interpersonal, or case management. Then, clients are provided with handouts and worksheets about the topic at hand, after which a discussion is facilitated. Clients are required to process the topic and required to commit to the same during the time in between sessions.

Depending on individual or group needs, some or all of the 25 topics are addressed. It is not necessary that every session covers one topic, as the therapist can extend some topics depending on the needs and circumstances.

Benefits of Seeking Safety Therapy

Seeking safety therapy is listed on the National Registry of Evidence-Based Practices and Programs (NREPP) as one of the strongly supported therapies for trauma, PTSD, and substance abuse disorders. Its benefits include:

• Addresses the co-occurring conditions of trauma/PTSD and substance use disorders.

• Learn skills to feel safe and cope in high-risk situations that can otherwise be harmful.

• Teaches techniques to make healthy life choices, build strong interpersonal relationships, and practice self-compassion and self-nurturing.

• Promotes a growth-oriented mindset, wherein clients learn how to work toward a more optimistic and fulfilling future.