How Can I Effectively Modify The Seeking Safety Model To Accommodate Individuals With Co-occurring Post-traumatic Stress Disorder And Substance Use Disorders Who Are Also Experiencing Complex Trauma Symptoms, Such As Dissociation And Emotional Dysregulation, Within The Context Of A Residential Rehabilitation Program?
To effectively modify the Seeking Safety model for individuals with co-occurring PTSD, substance use disorders, and complex trauma symptoms in a residential setting, consider the following structured approach:
1. Comprehensive Assessment
- Extended Initial Assessment: Use standardized measures to evaluate dissociation, emotional dysregulation, and trauma symptoms.
- Ongoing Monitoring: Regularly assess symptom severity and client needs throughout the program.
2. Flexible Session Structure
- Adapted Session Length: Extend session time to accommodate processing complex trauma.
- Prioritized Topics: Focus on safety, emotional regulation, and coping skills early on.
- Psychoeducation: Include education on complex trauma, dissociation, and emotional dysregulation.
3. Enhanced Safety Protocols
- Expanded Safety Focus: Emphasize emotional and psychological safety.
- Advanced Grounding Techniques: Introduce techniques like mindfulness, deep breathing, and tactile exercises.
- Safety Planning: Develop plans addressing dissociation and emotional crises, including a crisis box.
4. Mindfulness and Emotional Regulation
- Deeper Mindfulness Practices: Incorporate longer mindfulness exercises and guided imagery.
- DBT Techniques: Integrate skills for emotional regulation and distress tolerance.
5. Trauma Processing Adaptations
- Non-Confrontational Approaches: Use narrative exposure or trauma-focused CBT cautiously.
- Somatic Interventions: Incorporate yoga or somatic experiencing for physical processing.
6. Group and Individual Therapy Balance
- Modified Group Sessions: Ensure a safe environment with clear boundaries and step-out options.
- Individual Sessions: Provide for deeper support and tailored interventions.
7. Staff Training and Support
- Trauma-Informed Care Training: Educate staff on complex trauma, dissociation, and emotional dysregulation.
- Consultation Access: Allow clinicians to consult with trauma specialists.
8. Trauma-Informed Environment
- Safe Milieu: Create a calming environment with quiet spaces.
- Flexible Programming: Adjust activities to accommodate clients’ emotional states.
9. Medication Management
- Psychiatric Consultation: Collaborate on medications for PTSD or mood stabilization.
10. Cultural Sensitivity
- Culturally Adapted Materials: Ensure all resources respect clients’ backgrounds.
11. Aftercare Planning
- Comprehensive Discharge Plans: Include ongoing therapy, support groups, and community resources.
12. Evaluation and Research
- Outcome Tracking: Use client feedback and outcomes to refine the model.
- Research Encouragement: Contribute to the field by studying the approach.
This structured modification of the Seeking Safety model aims to create a supportive, flexible, and effective program for individuals dealing with complex trauma, PTSD, and substance use disorders.