Healing Without Reliving is possible.
In the field of trauma therapy, one of the most common questions clients ask is: “Do I have to talk about the worst moments of my life in order to get better?” The answer, for many people, can be no—especially when using the Seeking Safety program by Dr. Lisa M. Najavits. Seeking Safety is an evidence-based, present-focused treatment designed specifically for people struggling with both trauma/PTSD and substance use, though it’s increasingly used for individuals with trauma histories even without addiction. It emphasizes the here and now. The program has gained recognition for its empowering, compassionate approach to trauma recovery, especially for those early in treatment or who are not yet ready to revisit traumatic memories in depth.
Seeking Safety is a structured, manualized therapy that helps individuals achieve safety in their relationships, thinking, behavior, and emotions. Unlike traditional trauma-focused therapies that ask clients to process or re-experience traumatic memories (such as Prolonged Exposure or EMDR), Seeking Safety explicitly avoids trauma recounting. Instead, it focuses on building coping skills and helping clients attain stability in the present. Many trauma survivors struggling with co-occurring substance use disorders used to tend to receive fragmented care—one program for addiction, another for trauma, with little coordination or understanding of how the two interact. Seeking Safety was designed to integrate treatment for both conditions, while being flexible, adaptable, and easy to implement across a range of settings, including outpatient clinics, residential treatment programs, community health centers, prisons, and veteran services.
Seeking Safety is based on five key principles:
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Safety as the Priority
The main goal is to help clients attain safety—physical, emotional, cognitive, and interpersonal. The idea is that no healing can happen until safety is established. This principle drives every session and underpins every topic. -
Integrated Treatment of Trauma and Substance Use (or Other Risk Behaviors)
Trauma and addiction are deeply interconnected. Seeking Safety treats both simultaneously, helping clients understand how their substance use, dissociation, risky behaviors, or compulsions often serve as maladaptive ways to manage overwhelming trauma-related feelings. -
Focus on Ideals
The program emphasizes positive values and recovery-oriented goals. Each session highlights ideals such as honesty, compassion, healing, and self-care. This focus helps replace shame and hopelessness with meaning and direction. What do we have the ability to change for today? What is achievable now? And what do we need to hold patience for over time? -
Four Content Areas: Cognitive, Behavioral, Interpersonal, and Case Management
The program includes a blend of cognitive coping strategies (like grounding and thought restructuring), behavioral interventions (like managing triggers), interpersonal skills (like setting boundaries), and attention to practical needs (like housing or employment). -
Attention to Clinician Processes
Seeking Safety also prioritizes the well-being of clinicians. The manual includes notes on countertransference, burnout prevention, and therapist self-care, recognizing the emotional demands of trauma work.
Each Seeking Safety session follows a consistent structure, typically lasting 60 to 90 minutes, and can be delivered in individual or group formats. The sessions begin with a check-in focused on safety and recovery, followed by a quotation to inspire reflection, a review of homework, discussion of the topic for the day, and a check-out.There are 25 topics in the manual, and they can be used in any order. Some of the most popular include:
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Creating Meaning
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Asking for Help
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Honesty
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Coping with Triggers
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Self-Nurturing
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Setting Boundaries in Relationships
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Healing from Anger
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Taking Good Care of Yourself
Clients do not need to complete all 25 sessions to benefit from the program, and topics can be repeated based on need. This flexibility makes it ideal for high-turnover environments, such as shelters or correctional facilities, and also for tailoring to individual client goals. While many trauma treatments ask clients to go “back” to the trauma in order to move forward, Seeking Safety is firmly grounded in the present. It is not a trauma-processing therapy. Instead, it equips individuals with the tools to build stability, reduce self-destructive behaviors, and improve quality of life right now.
This makes Seeking Safety especially effective for:
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Clients in early recovery
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People with limited supports
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Individuals who dissociate under emotional distress
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Clients who are not ready to discuss their trauma
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Populations at high risk for retraumatization
It also offers a highly adaptable, gender-inclusive framework. Although it was initially developed with women in mind, Seeking Safety has been successfully adapted for men, LGBTQ+ individuals, adolescents, veterans, and more. Over 80 studies have been conducted on Seeking Safety across diverse populations, and the results consistently show reductions in PTSD symptoms, substance use, and related mental health issues. For example:
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A study in The Journal of Traumatic Stress found that veterans receiving Seeking Safety experienced significant improvements in trauma symptoms and coping skills.
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Another study with incarcerated women showed reduced substance use and greater emotional regulation after program completion.
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Community mental health programs have reported increased engagement, satisfaction, and retention among clients using this model.
Seeking Safety offers a collaborative, nonjudgmental therapeutic relationship. The clinician acts not as an expert telling clients what to do, but as a partner in recovery. The structure of the program allows clients to reclaim agency while also receiving clear, consistent support. Therapists are encouraged to bring their own authenticity, and the manual even includes language such as, “Say in your own words” or “Use your clinical judgment.” This strikes a balance between structure and flexibility, which helps foster trust and safety.
Trauma and PTSD can feel overwhelming, disorganizing, and isolating. For those also facing substance use, the journey can seem even more complicated. Seeking Safety offers a gentle, structured, and empowering path toward stability. It is a model rooted in compassion, strength-based values, and practical skills that restore hope and dignity.
Most importantly, it reminds clients: You don’t have to stay planted in the past in order to heal from it.