SEEKING SAFETY

OVERVIEW

Seeking Safety is a program designed to simultaneously treat post-traumatic stress disorder and substance use disorders in adolescent, youth, and young adult females. In an evaluation of the program, 33 adolescent girls were randomly assigned to receive either treatment as usual or treatment as usual in conjunction with the Seeking Safety intervention. Results indicated that the adolescents in the Seeking Safety group reported significantly lower levels of chemical involvement, fewer reasons for substance use, more positive post traumatic stress disorder assumptions, and fewer trauma-related symptoms, than participants in the treatment as usual control group.

DESCRIPTION OF PROGRAM

Target population: Female adolescents, youth, and young adults between the ages of 12 and 24 suffering from both post traumatic stress disorder and substance use disorders.

Seeking Safety is a therapy-based program aimed at treating females suffering from both post traumatic stress disorder and substance use disorders. Treatment consists of up to 25, 50-minute therapy sessions, either one-on-one or group-based, conducted over a three-month period. The program has five key components including: 1) emphasizing safety as a priority, 2) integrating treatment of both post traumatic stress and substance use disorders, 3) focusing on regaining ideals that have been lost due to the disorders, 4) using four content areas, including cognitive, behavioral, interpersonal, and case management, and 5) focusing attention on the clinician processes.

The cost of the Seeking Safety implementation manual is $40. Optional materials include the Seeking Safety Adherence Scale, (which can be downloaded free of charge at http://www.seekingsafety.org) 4.5 hours of training videos ($250), and on-site training and/or consultation (rates are negotiable).

EVALUATION(S) OF PROGRAM

Najavits, L.M., Gallop, R.J., Weiss, R.D. (2006). Seeking Safety therapy for adolescent girls with PTSD and substance use disorder: A randomized controlled trial. Journal of Behavioral Health Services & Research, 33, 453-463.

Evaluated population: 33 outpatient female adolescents meeting criteria for both post traumatic stress disorder and substance use disorders served as the sample in this evaluation. Seventy-nine percent of the sample were Caucasian, 12% were Asian/Pacific Islander, 3% were African American, 3% were Hispanic, and 3% were multi-ethnic.

Approach: Participants were first given psychological assessments to determine baseline diagnoses and symptomology. Researchers measured participants’ substance use, psychosocial problems associated with substance use, beliefs about substance use, reasons for using substances, post traumatic stress disorder assumptions, trauma related symptoms, and general psychopathology. Participants were then randomly assigned to receive either treatment as usual or treatment as usual in conjunction with the Seeking Safety program. Participants in both groups were allowed to attend any treatments they naturally would have sought. Participants in the Seeking Safety group received the program intervention in addition to their own chosen treatments.

The Seeking Safety treatment consisted of up to 25, 50-minute sessions that took place over a three-month period. The treatment was implemented in one-on-one therapy sessions.

Participants again were given the baseline questionnaires immediately following the end of treatment and at a three-month follow-up.

Results: Results indicated that, immediately following the treatment and at the three-month follow-up, participants in the Seeking Safety intervention group indicated significantly lower levels of chemical involvement problem severity (effect sizes ranged from .37 to 1.17 for various subscales), fewer reasons for substance use (effect size of 1.10), and more positive post traumatic stress disorder assumptions (effect size of 1.35), than participants in the treatment as usual control group. Additionally, at the three-month follow-up, participants in the treatment group indicated significantly fewer trauma-related symptoms (effect sizes ranged from .50 to .71 for various subscales) and lower levels of obsessive-compulsive (effect size of .33) and personality disorder (effect size of .49) symptoms. However, the two groups did not significantly differ on levels of psychosocial problems associated with substance use, on their beliefs about substance use, or on measures of other psychological disorders.

SOURCES FOR MORE INFORMATION

Information on implementing this program can be obtained from:

Lisa M. Najavits, Ph.D.

Director, Treatment Innovations

Professor of Psychiatry, Boston University School of Medicine

Lecturer, Harvard Medical School

12 Colbourne Crescent

Brookline, MA 02445

Phone: (617) 731-1501; Fax: (617) 701-1295

E-mail: Lnajavits@hms.harvard.edu

Website: http://www.seekingsafety.org/

References:

Program categorized in this guide according to the following:

Evaluated participant ages: Not cited

Evaluated participant grades: N/A

Program age ranges in the guide: Adolescence, Youth, Young Adults

Program components: Counseling/Therapy, Clinic/Provider-Based

Measured outcomes: Social and Emotional Health, Behavior Problems, Mental Health

KEYWORDS: Adolescence (12-17), Young Adulthood (17-24), Youth (16+), Clinic-based, Counseling/Therapy, Life Skills Training, Case Management, Gender-specific (female only), African American or Black, Hispanic or Latino, Asian or Pacific Islander, White or Caucasian, Mental Health, Post-Traumatic Stress Disorder, Obsessive Compulsive Disorder, Personality Disorder, Social Emotional Health, Substance Use, Marijuana Use, Illicit Drugs, Alcohol Use

Program information last updated on 1/6/09.

		© Child Trends 2003