A Treatment Manual for PTSD and Substance Abuse
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This manual presents the first empirically studied, integrative treatment approach developed specifically for co-occurring 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 specific units or topics, addressing a range of different cognitive, behavioral, and interpersonal domains. Each topic provides 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, topics can be conducted in any order and in a range of different formats and settings. The volume is designed for maximum ease of use with a large format, lay-flat binding, and helpful reproducible therapist sheets and handouts.
See also the author's self-help guide Finding Your Best Self, Revised Edition: Recovery from Addiction, Trauma, or Both, an ideal client recommendation.
Table of Contents
2. Conducting the Treatment
Introduction to Treatment/Case Management
PTSD: Taking Back Your Power
Detaching from Emotional Pain (Grounding)
When Substances Control You
Asking for Help
Taking Good Care of Yourself
Red and Green Flags
Integrating the Split Self
Setting Boundaries in Relationships
Getting Others to Support Your Recovery
Coping with Triggers
Respecting Your Time
Healing from Anger
Life Choices Game (Review)
Lisa M. Najavits, PhD, is currently Adjunct Professor at the University of Massachusetts Medical School and previously was on faculty at Harvard Medical School for 25 years and Boston University School of Medicine and the Veterans Affairs Boston Healthcare System for 12 years. She is author of over 180 publications, including the books Seeking Safety: A Treatment Manual for PTSD and Substance Abuse (for mental health professionals) and Finding Your Best Self, Revised Edition: Recovery from Addiction, Trauma, or Both (for general readers). She is Director of Treatment Innovations, which conducts research and training related to mental health and addiction. Dr. Najavits serves on the boards of numerous journals, including the Journal of Traumatic Stress, Journal of Gambling Studies,Journal of Dual Diagnosis, and Psychological Trauma, and has received awards including the Betty Ford Award from the Association for Medical Education and Research in Substance Abuse, the Emerging Leadership Award from the Committee on Women in Psychology of the American Psychological Association, the Early Career Contribution Award from the Society for Psychotherapy Research, and the Young Professional Award from the International Society for Traumatic Stress Studies. She also served as president of the Society of Addiction Psychology of the American Psychological Association. Her major clinical and research interests include addiction, trauma, co-occurring disorders, community-based care, veterans' mental health, development of new counseling models, and clinical trials research. She has a private psychotherapy practice in Massachusetts.
"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