Seeking Safety: An Integrated Group Model of Care for PTSD and Substance Use Disorders

Which came first, the chicken or the egg?

Which came first, the trauma or the substance use?

Many clinical programs treat PTSD or substance use disorders, but rarely both. Seeking Safety is an integrated model that treats both the PTSD and the substance use disorder at the same time and doesn’t worry which to treat first. The skills gained from Seeking Safety groups will help alleviate the symptoms of both PTSD and the substance use disorder.

The title of the Group, Seeking Safety, states the basic mission of the treatment. In this group the goal is for a person to be able establish and cultivate safety in their lives. Meaning, when a person has both active substance use and PTSD, the most urgent clinical need is developing safety.

So what does creating safety mean? What does it look like in real life?

Like so many things in life, that depends on the person. It could mean discontinuing substance use, reducing suicidality, minimizing exposure to HIV risk, letting go of dangerous relationships (such as domestic abuse and drug-using “friends”), gaining control over extreme symptoms (like dissociation), and stopping self-harm behaviors (such as cutting). Per Lisa Najavits (author and founder of Seeking Safety), “Many of these are self destructive behaviors that reenact trauma, particularly for victims of childhood abuse, who represent a large segment of people with this dual diagnosis.”

Seeking Safety is a present-focused group, meaning the focus is on present day and how to integrate coping skills into the present to create Safety. This group needs to be a safe place (hence the name) and so “diving into trauma” and providing the “gory details” of a traumatic event is not appropriate.

Cultivating safety is the first step in healing from trauma and substance use disorders. Once a person has the skills to cultivate safety they have successfully embarked on their personal journey of hope, resiliency and recovery.

“You yourself, as much as anybody in the entire universe, deserve your love and affection.” -Buddha (5th-century B.C. Indian philosopher).

mharkins-small

Michelle is a licensed clinical mental health counselor and alcohol & drug counselor at Counseling Associates. Michelle’s practice centers on a commitment to people being heard and respected regardless of the challenges that they may be experiencing. Michelle draws on her background in Cognitive Behavioral Therapy to help clients understand how their thoughts, feelings and core beliefs influence choices in their world. Michelle works together with her clients to find healthy solutions to create positive, sustainable life changes. Michelle serves NH residents in our Upper Valley location.



Michelle is the facilitator of Seeking Safety. Next group begins February 8, 2018. Seeking Safety is an ongoing group with new registered participants welcome at the first meeting of the month.


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