1.

Check-In (5 minutes per participant)

 Questions to ask:
o “How are you feeling today?”
o “What good coping strategies have you used since the last session?”
o “Have you had any substance use or engaged in unsafe behavior?”
o “Did you complete your last session’s commitment?”
o “Any updates on community resources?”
 Objective: This check-in reaffirms accountability, identifies any immediate issues, and
sets the session’s tone of self-reflection and growth(Seeking_Safety book).

2. Quotation (2 minutes)

 Choose a motivational quote, such as: “Although the world is full of suffering, it is full
also of the overcoming of it.” —Helen Keller
 Prompt: After reading, ask, “What does this quote mean to you in terms of safety?”
 Purpose: Using an uplifting quote encourages participants to think about safety in
positive terms and reinforces resilience(Seeking_Safety book).

3. Topic Discussion: Understanding and Prioritizing Safety (30-40 minutes)

 Introduction to Safety:
o Explain that the entire treatment centers around safety as the primary goal in
trauma and substance abuse recovery.
o Define safety to include abstaining from substances, setting boundaries, avoiding
self-harm, and fostering supportive relationships(Seeking_Safety book).
 Handout 1: “Safety Is the Most Important Priority Right Now!”
o Go through this handout, which stresses prioritizing safety above all else.
o Discussion questions:
 “What does safety mean to you?”
 “Why do you think it’s essential to establish safety as a first step in
recovery?”
  “Can you think of areas in your life where focusing on safety might
change things?”(Seeking_Safety book)(Seeking_Safety book).
 Self-Exploration:
o Encourage participants to reflect on specific ways they currently maintain or
neglect safety.
o Prompts:
 “In what areas of your life do you feel safest? Least safe?”
 “What practical steps could you take this week to reinforce a feeling of
safety in one area of your life?”
o Goal: By fostering this introspective dialogue, participants connect the concept of
safety to tangible actions in their daily lives(Seeking_Safety book).
 Safe Coping Skills (Handout 2):
o Present and discuss a list of 80+ safe coping strategies from the handout, such as
“ask for help,” “take good care of your body,” and “set boundaries.”
o Activity: Have participants identify at least two coping skills that resonate with
them and discuss how to integrate these into their routines. Examples could
include carrying a reminder of a positive memory or creating a daily ritual for
self-care.
o Objective: Reinforce actionable steps toward safety by encouraging participants
to choose coping mechanisms that are realistic and directly relevant to their lives
(Seeking_Safety book)(Seeking_Safety book).

4. Safety Plan Exercise

 Handout: “What Is Safety to You?”

 Guide participants through filling out sections where they describe what safety looks like
to them, including who and what makes them feel safe.
 Discussion: Invite them to think about how their identified safe places or practices could
serve as a foundation when they feel distressed.
 Purpose: This concrete exercise reinforces self-advocacy and encourages a proactive
approach to personal safety(Seeking_Safety book)(Seeking_Safety book).
5. Check-Out (5 minutes)

 End the session by asking each participant to:

o Reflect: “What’s one key takeaway from today’s session on safety?”
o Commit: Set a new commitment for the week, focusing on practicing one chosen
coping skill.
o Identify Resource: Determine a community resource they could reach out to for
additional support if needed.
 Purpose: This check-out solidifies the session’s learnings and promotes accountability,
helping participants leave with clear, positive intentions for the week ahead
(Seeking_Safety book)(Seeking_Safety book).
1. Check-In (5 minutes per participant)

 Ask Structured Questions:

o “How are you feeling today?”
o “What positive coping strategies have you applied since the last session?”
o “Have you encountered any substance use or unsafe behaviors?”
o “Did you fulfill your commitment from the previous session?”
o “Any updates on community resources or support systems?”
 Objective: Reinforce accountability and a supportive atmosphere, helping participants
reflect on their week’s progress and challenges.

2. Quotation (2 minutes)

 Select a Reflective Quote:

o Use Helen Keller’s quote, “Although the world is full of suffering, it is full also of
the overcoming of it.”
 Engage: After reading, prompt participants with, “What does this quote mean to you in
the context of your recovery journey?”
 Purpose: This encourages participants to reflect on their resilience and introduces the
theme of overcoming challenges to build safetyTopic Discussion: Safety as a Foundation
(30-40 minutes)**
 Introduce the Concept of Safety:
o Explain that the primary goal of Seeking Safety is to help them establish safety as
the foundation for all future recovery. Emphasize that safety in this context means
abstaining from substances, setting boundaries, preventing self-harm, and
nurturing supportive relationships.
 Review Handout 1: “Safety Is the Most Important Priority Right Now!”
o Go over this handout with the group, which stresses prioritizing safety above all
else.
o Discuss Unsafe vs. Safe Coping: Point out examples of unsafe vs. safe coping:
  Unsafe coping: Use substances, engage in impulsive behaviors, let others
take advantage of them.
 Safe coping: Seek help, set boundaries, take care of their bodies.
 Prompt questions:
 “What does safety mean to you?”
 “Can you think of a time when prioritizing safety made a positive
impact in your life?”
o Goal: Reinforce that safety must be their primary focus in overcoming trauma and
substance use【16:8†source(Seeking_Safety book)al Safety Challenges**:
o Encourage participants to discuss what safety looks and feels like to them.
o Prompts:
 “What areas in your life feel safe? Which don’t?”
 “How could you make specific environments or situations safer?”
o Objective: By fostering a personal understanding of safety, participants start to
see how it relates to their day-to-day lives.
 Safe Coping Skills (Handout 2):
o Present the extensive list of 80+ safe coping strategies. Examples include "asking
for help," "setting boundaries," "taking care of oneself," and "thinking before
acting."
o Activity: Guide participants to identify at least two coping skills they feel
comfortable trying out. Have them discuss how they could implement these skills
in real-life scenarios.
o Purpose: This step equips participants with practical tools they can begin using
immediately to foster a safer lifestyle【16:11†source】.

4. (Seeking_Safety book)ing Exercise**

 Use Handout 1: “What Is Safety to You?”

 Guide Participants Through Planning:
o Ask them to specify what they can do in moments of mild, moderate, and extreme
distress. This helps them develop an action plan for different levels of crisis,
enabling them to react calmly and with foresight.
  Discuss:
o “Who in your life contributes to your sense of safety?”
o “How could these people play a role in helping you stick to your safety plan?”
 Goal: Encourage participants to build a support network that reinforces their personal
safety goals .

5. **Check-Out - Reflect on the Session:

- Have each participant share one takeaway or insight from the session.
- Encourage them to make a specific commitment related to safety for the week ahead, such as
practicing a chosen coping skill or checking in with a community resource.
- **Ask**:
- “What’s one thing you learned about safety today?”
- “What will you commit to trying out before our next session?”

 Purpose: Reinforce the learning, ensuring each participant leaves with a practical safety-
related goal to work on.

This expanded structure focuses on embedding the concept of safety deeply into participants’
lives, offering them both emotional and practical tools to navigate their recovery process.
1. Check-In (up to 5 minutes per patient)

 Therapist: “Welcome back, everyone. Today, we’re diving into the topic of safety, but
first, let’s check in. Please take a moment to share how you’ve been since our last
session.”
 Therapist Prompt for Each Patient: “Did you try any safe coping strategies we
discussed last time? Were there moments when you felt safe or unsafe? If so, what was
that like for you?”
 Validation Example: “Thank you for sharing that, [Name]. It’s clear you’re becoming
more aware of what feels safe or unsafe. That awareness is an important step in building
safety into your life.”

2. Quotation (2 minutes)

 Therapist: “I’d like to start with a quote for today: ‘Although the world is full of
suffering, it is full also of the overcoming of it.’ This reminds us that even when things
feel difficult, there is hope in learning how to overcome challenges through safety.”
 Discussion Prompt: “When you hear this quote, what comes to mind for you? Does the
idea of overcoming suffering feel realistic or meaningful right now?”

3. Session Content: Discussing Safety as a Priority (30-40 minutes)

 Therapist Introduction to Handout 1: "Safety Is the Most Important Priority Right

Now!"
o Therapist: “Let’s look at this handout together. It emphasizes that safety is the
first and most important step in this recovery journey. Our goal today is to explore
what safety means to you personally and why it’s essential.”
o Questions to Connect the Material to Patients’ Lives:
 “What does safety mean to you, personally? It could be anything, from
physical safety to emotional boundaries.”
 “Why do you think safety has to come before other goals in recovery?”
 “Can you think of areas in your life where you already feel safe, and
others where safety is still a challenge?”
o Relate Safety to Trauma and Substance Use: Explain that achieving safety is
particularly important for those with PTSD and substance abuse, as it helps
prevent self-destructive behaviors, reduce risk, and manage symptoms like
flashbacksthe Safe Coping Skills List (Handout 2)** (optional if time permits):
o Therapist: “Here’s a list of coping strategies designed to help you stay safe,
especially in challenging moments. Let’s go over some together, and feel free to
mention any that resonate with you.”
o Sample Prompts for Discussion:
 “Is there a skill on this list that you think could help you this week?”
 “Are there coping strategies here that you’ve tried in the past? What was
that experience like for you?”
 Encouraging Prioritization of Safety:
 o Therapist: “Part of our work here is to make safety the main focus. This may feel
new or even challenging, but as you work on making safer choices, it builds a
foundation for the rest of your recovery.”

4. Check-Out (up to 5 minutes)

 Therapist: “To wrap up, I’d love to hear one thing you took away from today’s session.
It could be a new insight about safety or a coping skill you’d like to try.”
 Commitment Setting: “Looking ahead, what is one specific action you can take to
prioritize safety until our next session? It could be something small, like practicing a
coping skill or reaching out to someone supportive.”
 Examples of Commitments:
o “This week, I’ll practice reaching out to a supportive friend when I feel stressed.”
o “I’ll focus on a specific coping skill, like grounding, when I feel overwhelmed.”
 Therapist Reminder: “Remember, safety is a journey. Even small steps toward creating
a safe environment for yourself are powerful.”
1. Check-In (10-15 minutes total, up to 5 minutes per patient)

 Therapist Opening: “Welcome back, everyone. Today, we’re focusing on safety—a

foundation for healing and stability. Before we begin, let’s take a few minutes to check in
and hear from each of you about how your week went.”
 Questions for Each Patient (as time permits):
o Therapist: “Did you try using any safe coping skills since our last session?”
o Therapist: “Were there any times this week where you felt unsafe or unsafe
behaviors were triggered? How did you respond in those moments?”
o Therapist: “Did you have a chance to connect with any community resources or
reach out to supportive people as we discussed?”
 Validation Example (after each patient’s response): “Thank you for sharing, [Name].
It sounds like you’re becoming more aware of situations that feel safe or unsafe. That’s a
huge step, and each moment of awareness supports your journey towards recovery.”

2. Quotation (2-3 minutes)

 Therapist: “I want to share a quote with you to set the tone for today’s topic: ‘Although
the world is full of suffering, it is full also of the overcoming of it.’ This reminds us that
while pain and challenges are real, so is the possibility of resilience and healing through
choices that support safety.”
 Therapist Prompt for Reflection: “As you hear this quote, take a moment to think
about what ‘overcoming’ might look like in your own life. Is there a time when you felt
safe enough to face a challenge? Or, does the idea of overcoming suffering feel distant or
difficult right now? Feel free to share any thoughts.”
 Therapist Reinforcement: “Overcoming suffering often starts with choosing actions
that support safety. This is a journey, and each small step contributes to resilience.”

3. Session Content: Safety as a Foundation for Recovery (30-40 minutes)

Introduction to Safety as a Priority

 Therapist: “Today, we’ll focus on making safety the most important part of your
recovery. For many people who experience PTSD and substance use, feeling unsafe or
engaging in risky behaviors can be familiar patterns. Our goal here is to understand safety
as a powerful tool for healing.”

Introducing Handout 1: "Safety Is the Most Important Priority Right Now!"

 Therapist: “Let’s take a look at Handout 1, ‘Safety Is the Most Important Priority Right
Now!’ This handout emphasizes the idea that before we can work on deeper healing, we
need to establish safety in our lives—both physical and emotional. Without safety, it’s
difficult to move forward with other parts of recovery.”
 Discussing Personal Definitions of Safety:
 o Therapist Prompt: “When you think of safety, what comes to mind for you? It
could be physical safety, like being in a secure environment, or emotional safety,
like feeling respected by others. How would you describe it?”
o Follow-up Example: “What are some situations or people that make you feel
safe? Conversely, are there situations or people where you feel your sense of
safety is compromised?”
 Exploring Why Safety is a Priority in Recovery:
o Therapist Prompt: “Why do you think it’s essential to focus on safety before
other goals in recovery? For example, how might safety help you avoid triggers or
handle moments of distress without turning to substances?”
o Therapist Reinforcement: “Making safety a priority can help prevent self-
destructive behaviors, reduce the risk of relapse, and create a more stable
foundation to address PTSD symptoms.”

Exploring Safe Coping Skills (Handout 2)

 Therapist Introduction: “Now, let’s look at Handout 2, which lists safe coping skills.
These are practical strategies you can use in moments of stress or when facing
challenges. The goal is to build a toolkit of skills that can help you stay safe.”
 Prompting for Specific Skills:
o Therapist: “Is there a particular skill on this list that you think could help you
this week? Or maybe a skill you’ve used before that you’d like to strengthen?”
o Therapist: “Some people find grounding techniques helpful, while others rely on
reaching out to supportive friends. Are there any skills here you’d like to try?”
 Encouraging Skill Practice and Integration:
o Therapist: “Practicing safe coping skills is like building a muscle. Each time you
use a skill, you’re reinforcing your ability to stay safe. Let’s set a small goal to
use at least one of these skills during the week ahead.”

Reflecting on Unsafe Behaviors and Transitioning to Safety

 Therapist Prompt: “We’ve all had moments where we turned to less safe ways of
coping, whether that’s substance use, risky relationships, or avoiding our feelings. Take a
moment to reflect: Are there any behaviors you’d like to let go of because they don’t
support your safety?”
 Therapist Reinforcement: “It’s natural to feel hesitant about making changes, but each
time you choose safety, you’re empowering yourself to overcome challenges. Even if it’s
hard, each small choice toward safety is an act of self-care.”

4. Check-Out (5 minutes)

 Therapist Wrap-Up Prompt: “As we close today, I’d like each of you to share one
thing you’ll take away from our discussion on safety. It could be a specific coping skill, a
new way of thinking about safety, or a commitment to yourself.”
 Setting a Commitment for the Week:
 o Therapist Prompt: “Before our next session, I encourage each of you to choose
one action to support your safety. This could be practicing a skill from the list,
reaching out to a friend, or avoiding a place or person that feels unsafe.”
 Examples of Commitment Statements:
o “This week, I’ll practice a grounding exercise when I feel anxious.”
o “I’ll call a supportive friend if I start to feel stressed or unsafe.”
o “I’ll try to avoid [specific unsafe behavior] and replace it with a safe coping
skill.”
 Therapist Reminder: “Remember, safety is a gradual process. Even small steps can
make a big difference. Each commitment you make reinforces your ability to create a
safer, more stable foundation for healing.”
 Final Encouragement: “Thank you all for your openness and commitment today.
Recovery is challenging, but by focusing on safety, you’re laying the groundwork for
everything else. I look forward to hearing how your week goes.”