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

www.lafrontera.orgppenn@lafrontera.org

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)