Creating Change: A Past-Focused Model for Trauma and/or Addiction


Presented by: Lisa M. Najavits, PhD. Director of Treatment Innovations; and adjunct professor, University of Massachusetts Medical School. She was on the faculty of Harvard Medical School for 25 years and was a research psychologist at Veterans Affairs Healthcare System, Boston for 12 years. She is author of over 200 professional publications, as well as the books Seeking Safety (a treatment manual for trauma and addiction); Finding Your Best Self: Recovery from Addiction, Trauma, or Both; and A Woman’s Addiction Workbook. 

This presentation offers a description and implementation of Creating Change, a counseling model for trauma and addiction. The new model is designed to offer additional work beyond Seeking Safety, and can be conducted one after the other (Seeking Safety first, then Creating Change) or at the same time.  Where Seeking Safety teaches coping skills in the present, the new model focuses on processing of past memories and emotions.  Twenty-three topics are offered, including “Honor Your Survival”, “Why Addiction”, “Tell Your Story”, “Influences: Family, Culture, Community” and “Being In Your body”. Like Seeking Safety, the new model offers flexible, an integrated approach linking trauma and addiction; and can be used for group or individual treatment; diverse settings and clinicians; and all types of trauma and addictions. Similarities and differences with existing evidence-based PTSD and/or SUD treatments are described.  We also address key issues such as client readiness and engagement, clinician selection, complex cases, evidence-base, and the historical context of past-focused treatment models. We review two pilot studies and a randomized controlled trial on Creating Change, all with positive outcomes. The new model can be used alone or in combination with any other treatment.


  1. To understand the use of past- vs. present-focused therapies.
  2. To describe Creating Change, a new past-focused counseling model for trauma and addiction.
  3. To describe how Creating Change can be used with Seeking Safety and any other treatment

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