Seeking Safety and Creating Change: two paths for trauma and substance use

Trauma and substance use often affect one another. Substances may become a way to cope with memories, emotions, sleep, or a nervous system that feels constantly on alert. Treatment does not have to begin by revisiting the past.

Seeking Safety is present-focused

Seeking Safety, developed by psychologist Lisa M. Najavits, is an evidence-based model for trauma and/or substance use. It focuses on building safety in the present. Sessions may explore grounding, coping with triggers, asking for help, setting boundaries, self-compassion, and creating structure without requiring detailed discussion of traumatic events.

Creating Change is past-focused

Creating Change is a newer evidence-based model from Treatment Innovations. It is designed for people who want to process past experiences connected with trauma and/or addiction. It can be used on its own or alongside Seeking Safety. Readiness, stability, client preference, and therapist competence all matter when deciding whether past-focused work is appropriate.

They are related, not interchangeable

One approach is not a “better” version of the other. Seeking Safety can help strengthen present-day coping and reduce risk. Creating Change offers a structured way to work with the past. Some people may use one model; others may use both at different stages.

What sessions are like

Both models are structured and collaborative. A therapist explains the approach, checks that it fits your goals, and adapts pacing to your circumstances. Therapy should never pressure you to disclose details before you are ready.

This article provides general information and is not a diagnosis or treatment recommendation. Discuss your circumstances and treatment options with a qualified professional.