This much-needed manual presents the first empirically studied, integrative treatment approach developed specifically for PTSD and substance abuse.

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This much-needed manual presents the first empirically studied, integrative treatment approach developed specifically for PTSD and substance abuse. For persons with this prevalent and difficult-to-treat dual diagnosis, the most urgent clinical need is to establish safety to work toward discontinuing substance use, letting go of dangerous relationships, and gaining control over such extreme symptoms as dissociation and self-harm. The manual is divided into 25 topics, each of which forms the basis for one or more sessions. Covering a range of cognitive, behavioral, and interpersonal issues, topics include highly practical tools and techniques to engage patients in treatment; teach "safe coping skills" that apply to both disorders; and restore ideals that have been lost, including respect, care, protection, and healing. Structured yet flexible, sessions can be conducted in any order and in a range of settings. The volume is designed for maximum ease of use with a large format, lay-flat binding, and helpful reproducible therapist sheets and handouts.

"Fabulous! This treatment manual provides practical, clearly described procedures for treating an extremely difficult group of clients. The organization of the treatment is superb. From my perspective, the most important parts of a comprehensive treatment are here attention to the client's safety, targeting substance use simultaneously with targeting PTSD, integrating ideals and values (I love the quotations!), a core of cognitive-behavioral interventions, a focus on interpersonal relationships, and attention to the needs of the therapist. Very impressive. Obviously written by an experienced clinician."
-Marsha Linehan, PhD, University of Washington

"As empirically guided treatment manuals begin to emerge in greater numbers and varying quality, Najavits maintains an essential and elegant balance between a lucid map of treatment directions, on the one hand, and the complex dynamics of the clinical territory on the other. This is a very important work that I highly recommend for clinicians of every stripe."
-Howard J. Shaffer, PhD, CAS, Harvard Medical School

401 Pages

1. Overview

2. Conducting the Treatment

Treatment Topics

Introduction to Treatment/Case Management Safety

PTSD: Taking Back Your Power

Detaching from Emotional Pain (Grounding)

When Substances Control You

Asking for Help

Taking Good Care of Yourself

Compassion

Red and Green Flags

Honesty

Recovery

Thinking

Integrating the Split Self

Commitment

Creating Meaning

Community Resources

Setting Boundaries in Relationships

Discovery

Getting Others to Support Your Recovery

Coping with Triggers

Respecting Your Time

Healthy Relationships

Self-Nurturing

Healing from Anger

Life Choices Game (Review)

Termination

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