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This much-needed manual presents the first empirically studied, integrative treatment approach developed specifically for PTSD and substance abuse. For persons with this prevalent and difficult-to-treat dual diagnosis, the most urgent clinical need is to establish safety to work toward discontinuing substance use, letting go of dangerous relationships, and gaining control over such extreme symptoms as dissociation and self-harm. The manual is divided into 25 topics, each of which forms the basis for one or more sessions. Covering a range of cognitive, behavioral, and interpersonal issues, topics include highly practical tools and techniques to engage patients in treatment; teach "safe coping skills" that apply to both disorders; and restore ideals that have been lost, including respect, care, protection, and healing. Structured yet flexible, sessions can be conducted in any order and in a range of settings. The volume is designed for maximum ease of use with a large format, lay-flat binding, and helpful reproducible therapist sheets and handouts. --- from the publisher Reviews: "Fills a tremendous gap in treatment resources....Provides clinicians with an empirically based and well-developed treatment program that enables them to intervene in comorbid SUD and PTSD in an integrated way....Provides a breath of fresh air by rising above the often contentious debate on whether cognitive behavioral therapy (CBT), psychodynamic interventions, or 12-step-oriented approaches are the best treatment model....The manual is well organized, easy to use, and relevant to the treatment needs of individuals with comorbid PTSD and SUD. It is an innovative, flexible, and practical program that is adaptable to a variety of treatment settings. Although this manual is particularly useful for clinicians, I highly recommend it as a resource for students and researchers who seek to gain a better understanding of the treatment needs of individuals who have concomitant SUD and PTSD as well." -Criminal Justice Review "This landmark volume presents a cutting-edge approach to the treatment of patients who depend on drugs to soothe the pain of PTSD. In stunning detail, Najavits shows how the same therapist can treat both conditions concurrently. Her kinder and gentler approach is a welcome change from traditional confrontational interventions. The volume is enriched by her empathy and wisdom. All therapists attempting to help these patients should have this book to guide them." -Aaron T. Beck, MD, University Professor of Psychiatry, University of Pennsylvania "Fabulous! This treatment manual provides practical, clearly described procedures for treating an extremely difficult group of clients. The organization of the treatment is superb. From my perspective, the most important parts of a comprehensive treatment are here-attention to the client's safety, targeting substance use simultaneously with targeting PTSD, integrating ideals and values (I love the quotations!), a core of cognitive-behavioral interventions, a focus on interpersonal relationships, and attention to the needs of the therapist. Very impressive. Obviously written by an experienced clinician." -Marsha M. Linehan, PhD., University Professor of Psychology, University of Washington "Born of experience and energized by passion, this carefully crafted and thoughtful treatment manual will guide clinicians through the tricky waters of substance abuse and PTSD treatment. Seeking Safety will help clinicians decide what to do and how to do it well. As empirically guided treatment manuals begin to emerge in greater numbers and varying quality, Najavits maintains an essential and elegant balance between a lucid map of treatment directions, on the one hand, and the complex dynamics of the clinical territory on the other. This is a very important work that I highly recommend for clinicians of every stripe." -Howard J. Shaffer, PhD, CAS, Director, Division on Addictions, Harvard Medical School • sample chapter (pdf) Table of Contents: 1. Overview 2. Conducting the Treatment Treatment Topics Introduction to Treatment/Case Management Safety PTSD: Taking Back Your Power Detaching from Emotional Pain (Grounding) When Substances Control You Asking for Help Taking Good Care of Yourself Compassion Red and Green Flags Honesty Recovery Thinking Integrating the Split Self Commitment Creating Meaning Community Resources Setting Boundaries in Relationships Discovery Getting Others to Support Your Recovery Coping with Triggers Respecting Your Time Healthy Relationships Self-Nurturing Healing from Anger Life Choices Game (Review) Termination About the Author: Lisa M. Najavits, PhD, is professor of psychiatry, Boston University School of Medicine; and lecturer, Harvard Medical School. She is a research psychologist at Veterans Affairs (VA) Boston Healthcare System and the Bedford VA; clinical associate, McLean Hospital; and director of Treatment Innovations. Her major clinical and research interests are substance abuse, trauma, co-morbidity, behavioral addictions, veterans' mental health, community-based care, development of new psychotherapies, and outcome research. She is author of over 175 professional publications, as well as the books Seeking Safety: A Treatment Manual for PTSD and Substance Abuse; A Woman's Addiction Workbook; and the upcoming book Creating Change: A Past-Focused Treatment Manual for Trauma and Addiction. She has served as president of the Society of Addiction Psychology of the American Psychological Association; and is on various advisory boards including the Journal of Traumatic Stress; the Journal of Gambling Studies; and Addiction Research and Theory. She has received various awards, including the 1997 Young Professional Award of the International Society for Traumatic Stress Studies; the 1998 Early Career Contribution Award of the Society for Psychotherapy Research; the 2004 Emerging Leadership Award of the American Psychological Association Committee on Women; and the 2009 Betty Ford Award of the Addiction Medical Education and Research Association. She is a fellow of the American Psychological Association; board certified in behavioral therapy; a licensed psychologist in Massachusetts; and conducts a psychotherapy practice. She received her PhD in clinical psychology from Vanderbilt University and her bachelor's degree with honors from Barnard College of Columbia University.
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