“Seeking Safety” from trauma
July 1, 2015 § Leave a comment
By Kay M. Johnson, LICSW
For healthcare professionals, understanding trauma has never been more important. According to the Kaiser Permanente/CDC Adverse Childhood Experiences Study (ACE), conducted with over 17,000 patients, 63% of public health clients have experienced at least one childhood trauma. This study confirmed that traumatic experiences often result in significant neurological, biological, psychological, and social effects on the individual.
Emotional, verbal and physical abuse, a household member with substance abuse or mental health issues, a household member involved in the criminal justice system, and other adverse childhood experiences often have a profound impact on individuals. These experiences often lead to mental health or other chronic health problems like substance abuse, lung/heart/liver disease, and STDs. Given the risks involved, it is important that medical and behavioral health professionals understand trauma and learn strategies for helping those in need.
The “Seeking Safety” approach
For more than a decade, there has been a national focus on increasing understanding of trauma and on training healthcare professionals on how to work with individuals who have experienced trauma. However, the amount of training and understanding varies widely among healthcare professionals. To help clinicians increase their knowledge and learn approaches to help their patients, Lisa M. Najavits, PHD, developed “Seeking Safety: A Treatment Manual for PTSD and Substance Abuse” (2002, NY: Guilford Press). It is an evidence-based counseling model originally designed to help people attain safety from trauma and/or substance abuse, and it is now used as a stabilization coping skills model used to address a number of life problems.
The approach takes on both trauma and co-occurring disorders at the same time, but it does not require clients to provide detailed accounts of disturbing trauma memories. Rather, clients are provided information about how trauma or other life experiences may affect someone and are supported as they notice the impact in their own life. They are empowered to take steps that will lessen the negative impact and support their strengths despite the adversity they have experienced. Ultimately, the goal is to help clients attain safety in their relationships, thinking, behavior, and emotions.
Training at Commonwealth Care Alliance
Not long ago, I presented a “Seeking Safety” workshop for a group of Commonwealth Care Alliance healthcare professionals. The training was particularly meaningful because Commonwealth Care Alliance clinicians work with many individuals who experience trauma, particularly members in the One Care program. Issues related to trauma, including mental illness, drug use, homelessness, and domestic violence are, unfortunately, not uncommon in this population.
During the training, I offered information regarding the impact of trauma and presented the Seeking Safety approach to treating members with trauma. With the goal of increasing empathy and understanding, participants took part in role-playing exercises and discussions and were given resources for assessment and treatment. The participants at the training were highly involved in discussing their work with clients, the challenges they experience (especially chronic relapse, severe and chronic physical health problems which are aggravated by PTSD responses, and mental health problems of depression, anxiety, psychotic disorders). Most challenging are clients who are especially demanding or hopeless. In addition to learning strategies and skills, participants spent some time talking about their own personal self-care as a way to work combat vicarious trauma and burnout.
Workshops like “Seeking Safety” are part of a large movement in the healthcare community to change the way we think about trauma and substance abuse. It’s also part of an ongoing and critical process that will give clinicians the training they need to make a difference in the lives of vulnerable individuals.