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Implementing Seeking Safety

Implementing Seeking 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).

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Implementing Seeking Safety

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  1. 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)

  2. Pat Penn, PhDAmy Tilley, PsyDWendy Layne, MALa Frontera Center, Inc.Tucson, AZwww.lafrontera.orgppenn@lafrontera.org

  3. 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

  4. Co-occurring Conditions:Now What?

  5. 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

  6. First Steps • Site – Casa de Vida - residential • Staff – psychology interns • Train – books, website • Clients – mixed gender groups • Assessments – LASC, client satisfaction, qualitative

  7. 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

  8. Our Results Thus Far Residential Setting Clients with co-occurring conditions Rotating psychology intern facilitators

  9. Repeated Measures AnalysisPTSD Scores – Combined Data 2007-09 Significant Decrease for Total (N=17)

  10. PTSD Scores - Female FacilitatorsCombined Data 2007 - 09

  11. PTSD Scores - Male FacilitatorsCombined Data 2007 - 09

  12. PTSD Scores By Year

  13. Satisfaction DataCombined Facilitators 2009

  14. 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

  15. 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

  16. 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”

  17. 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

  18. Further Dissemination • Presentations – LFC staff, regional meetings • Interns - Post-docs take to other sites • Other LFC staff start using it

  19. Lessons Learned • Choose what to implement wisely • Start small – 1 willing person (interns!) • Start at a group friendly site • Experiment with adaptations

  20. Lessons Learned, cont. • Collect data over time • Assign one person to manage data • Supervise more closely • Communicate with author • Give presentations

  21. “Although the world is full of suffering, it is full also of the overcoming of it”- Helen Keller(quote used in the manual)

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