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Over 90 percent of clients in public behavioral health have experienced at least one traumatic event in their life, according to the National Council for Behavioral Health, and trauma is at the root of most mental and substance use disorders. Trauma-informed treatments are therefore essential in effectively treating behavioral health conditions.
At FHE Health, best practices like EMDR therapy (“Eye Movement Desensitization and Reprocessing”) and neuro-rehabilitative services have helped many people, by rewiring their traumatized brain for better health; and holistic interventions like massage and integral breathwork therapy promote mind-body recovery.
Psychoeducation, in the form of a trauma-informed curriculum for individuals and groups, is another best practice that FHE Health employs to treat trauma. We recently sat down with Dr. Titus Tucker, Ed.D, LCSW, SAP, to learn more about it. As Director of Clinical Services, Dr. Tucker is overseeing the implementation of a curriculum called “Seeking Safety.” Seeking Safety educates clients about trauma and empowers them with coping tools for managing it. In the sections that follow, you’ll find out more about this initiative, with the help and expertise of Dr. Tucker.
What Seeking Safety Is and How It Works
Seeking Safety is a six-week group curriculum designed for treating trauma and its effects. The curriculum “was developed in the late 1990s and 2000 and then revised in 2024 with updated material,” Dr. Tucker said.
Clients meet once a week in a three-hour class led by a skilled, master’s-level facilitator and make their way through lessons in the Seeking Safety workbook. Each chapter offers a lesson about the nature of trauma and suggests some simple exercises for self-reflection and/or managing triggers. Topics include how to find emotional safety and grounding, improve self-regulation, and establish healthy boundaries in relationships, for example.
How Eligibility Is Determined
Eligibility is determined at the start of treatment with the PCL5 assessment: “This is a self-administered questionnaire that’s helpful for gauging the level of clients’ trauma experience,” Dr. Tucker said. “It gives us a good guide as to whether to add treatment of trauma to a client’s history. In addition to the PCL5, clients complete a biopsychosocial assessment, family history, and self-reporting through counseling provides insight into the level of trauma experienced before entering treatment.”
Individualized Trauma Care
The PCL5 assessment also “individualizes our care for the patient,” Dr. Tucker said. He went on to explain how trauma and perceptions of it can vary widely between individuals:
From a clinical perspective, I can define trauma from multiple perspectives. Someone might have hypervigilance from a sexual assault or increased anxiety because of violence; or they might be a first responder who experiences traumatic events daily.
Similarly, “a history of overdosing may not be traumatic from the client’s perspective, even if it seems traumatic to the clinician.”
The PCL5 “allows for a more individualized treatment plan that enables the client to learn coping skills specific to their individual symptoms.” For example, “if they are having flashbacks or increased anxiety and depression, their treatment can be more targeted to support their stabilization.”
A Focus on Teaching Coping Skills
In addition to educating clients about trauma, Seeking Safety teaches clients coping mechanisms that they can use in life after treatment. Here is how Dr. Tucker put it:
Clients are with us less than 90 days. That’s not a long time. And when you work with trauma, from a psychological standpoint you want to make sure patients are learning specific coping skills. Utilizing the curriculum allows us to educate clients about coping mechanisms as well as triggers to be aware of. We’re giving clients the opportunity to discuss how they can take care of themselves post-treatment, via counseling.
This focus on coping skills can be especially helpful for substance use disorder clients, who “experience environmental factors while managing the recovery process that may result in traumatic experiences,” Dr. Tucker added.
The Rationale and Supporting Research for Seeking Safety
What inspired the implementation of this curriculum at FHE?
“Clients were coming into treatment with high levels of trauma,” Dr. Tucker said, “and Seeking Safety was an evidence-based way to treat deep trauma and substance use that are intertwined.”
The Substance Abuse and Mental Health Administration (SAMHSA) was also encouraging facilities to adopt a trauma-informed guide like Seeking Safety. Dr. Tucker cited findings by SAMHSA that the skills-based curriculum improves talk therapy outcomes.
The Goals of Seeking Safety
What are the goals of the Seeking Safety initiative, and how are they measured?
“The goal is to help the patient develop coping mechanisms to help them feel safer,” Dr. Tucker said. “Group therapy is one of the most effective forms of inpatient treatment, so if patients are participating in group therapy, you measure their success based on their individual skill set and individual sessions.”
Words of Encouragement
What might make this treatment worth exploring for those who have tried treatment for PTSD or other trauma-related mental health issues, but without success?
Dr. Tucker offered this perspective:
Seeking Safety is worth exploring because it’s an evidence-based model, and some people have had trauma but never had trauma-informed therapy. This is education-based, non-threatening, and doesn’t encourage you to go deep into your experiences. It’s also facilitated by a clinician and gives you resources and support from a group therapy perspective.
Finally, and most importantly, at the heart of this approach is the evidence-based belief that you can heal from your trauma — and the empowering conviction that you can learn how.
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