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ImplementingSeeking Safety
Presented at the NIDA CTN Pre-Steering Committee Dissemination Workshop, Bethesda, MD, October, 2009
Supported by the California-Arizona Node of the NIDA Clinical Trials Network (U10 DA105815)
Pat Penn, PhDAmy Tilley, PsyDWendy Layne, MA
La Frontera Center, Inc.Tucson, AZ
La Frontera Center, Inc.
One of the original CMHCs, 1968 Largest community behavioral health
organization in Arizona; top 15% in US Over $50 million annual budget 21 sites and 15,000+ clients served in
FY 08/09 Capitated funding predominant
Co-occurring Conditions:Now What?
Why We Initially Choose Seeking Safety
Client need Demonstrated efficacy Treatment for a wide range of
clientele Treatment is relatively brief Focus on strengths and building
positive coping skills rather than on reprocessing the trauma
Appeared to be user friendly Flexibility possible
First Steps
Site – Casa de Vida - residential Staff – psychology interns Train – books, website Clients – mixed gender groups Assessments – LASC, client
satisfaction, qualitative
Next Steps Tried adaptations:
– Open enrollment
– Clients choose topics
– Vary order of topics
– Extend/repeat some topics Supervision Looked at data Talked with Dr. Najavits
Our Results Thus Far
Residential Setting
Clients with co-occurring conditions
Rotating psychology intern facilitators
Repeated Measures AnalysisPTSD Scores – Combined Data 2007-09
Significant Decrease for Total (N=17)
PTSD Scores - Female FacilitatorsCombined Data 2007 - 09
PTSD Scores - Male FacilitatorsCombined Data 2007 - 09
PTSD Scores By Year
Satisfaction DataCombined Facilitators 2009
Observations from Facilitators
Many clients seem to feel relaxed in the emotionally “managed” atmosphere
Most clients leave group in a positive, upbeat mood
Clients refer to the tools they are learning when outside of group
What Clients Have Said:
Noted improvements in overall self-esteem
Greater confidence coping with PTSD and SA triggers
Said they felt “safe” in group Topics and handouts were very
useful
Client quotes include:
“This is my favorite group” “I have learned a lot of tools” “I have used a lot of the tools outside
of group” “I would like to go through the series
again as a refresher”
Our Data Suggest
The method can be successfully used with mixed gender groups
Adaptations are feasible (and may increase client engagement)
Clients and facilitators like it Closer supervision may be needed,
esp. re gender considerations
Further Dissemination
Presentations – LFC staff, regional meetings
Interns - Post-docs take to other sites Other LFC staff start using it
Lessons Learned
Choose what to implement wisely Start small – 1 willing person (interns!) Start at a group friendly site Experiment with adaptations
Lessons Learned, cont.
Collect data over time Assign one person to manage data Supervise more closely Communicate with author Give presentations
“Although the world is full of suffering, it is full also of
the overcoming of it”
- Helen Keller
(quote used in the manual)