"This landmark volume presents a cutting-edge approach to the treatment of patients who depend on drugs to soothe the pain of PTSD. In stunning detail, Najavits shows how the same therapist can treat both conditions concurrently. Her kinder and gentler approach is a welcome change from traditional confrontational interventions....All therapists attempting to help these patients should have this book to guide them."

--Aaron T. Beck, MD, University of Pennsylvania

"Fabulous! This treatment manual provides practical, clearly described procedures for treating an extremely difficult group of clients. The organization of the treatment is superb. From my perspective, the most important parts of a comprehensive treatment are here attention to the client's safety, targeting substance use simultaneously with targeting PTSD, integrating ideals and values (I love the quotations!), a core of cognitive-behavioral interventions, a focus on interpersonal relationships, and attention to the needs of the therapist. Very impressive. Obviously written by an experienced clinician."

--Marsha Linehan, PhD, University of Washington

"As empirically guided treatment manuals begin to emerge in greater numbers and varying quality, Najavits maintains an essential and elegant balance between a lucid map of treatment directions, on the one hand, and the complex dynamics of the clinical territory on the other. This is a very important work that I highly recommend for clinicians of every stripe."

--Howard J. Shaffer, PhD, CAS, Harvard Medical School

Submitted By Publisher, May, 2004

This much-needed manual presents the first empirically studied, integrative treatment approach developed specifically for PTSD and substance abuse. For persons with this prevalent and difficult-to-treat dual diagnosis, the most urgent clinical need is to establish safety to work toward discontinuing substance use, letting go of dangerous relationships, and gaining control over such extreme symptoms as dissociation and self-harm. The manual is divided into 25 topics, each of which forms the basis for one or more sessions. Covering a range of cognitive, behavioral, and interpersonal issues, topics include highly practical tools and techniques to engage patients in treatment; teach "safe coping skills" that apply to both disorders; and restore ideals that have been lost, including respect, care, protection, and healing. Structured yet flexible, sessions can be conducted in any order and in a range of settings. The volume is designed for maximum ease of use with a large format, lay-flat binding, and helpful reproducible therapist sheets and handouts.

1. Overview
2. Conducting the Treatment
Treatment Topics
Introduction to Treatment/Case Management Safety
PTSD: Taking Back Your Power
Detaching from Emotional Pain (Grounding)
When Substances Control You
Asking for Help
Taking Good Care of Yourself
Compassion
Red and Green Flags
Honesty
Recovery
Thinking
Integrating the Split Self
Commitment
Creating Meaning
Community Resources
Setting Boundaries in Relationships
Discovery
Getting Others to Support Your Recovery
Coping with Triggers
Respecting Your Time
Healthy Relationships
Self-Nurturing
Healing from Anger
Life Choices Game (Review)
Termination