Practitioner training and user experience of Seeking Safety for people with complex post-traumatic stress disorder and substance use disorder

Background Post-traumatic stress disorder (PTSD) develops because of a profoundly traumatic experience such as combat situations, interpersonal violence, accidents, and natural disasters. Symptom manifestation may include recurring intrusive thoughts and memories, low mood, hypervigilance, disrupted sleep patterns, emotional dysregulation, and reduced attention span. Individuals affected by complex PTSD may withdraw from society or engage in harmful, risky and dangerous behaviours or develop substance use disorder (SUD). The purpose of this scoping review is to consider available evidence around the use of Seeking Safety as a treatment modality in individuals with complex PTSD and SUD. In particular it aims to identify the available evidence relating to Seeking Safety with regards to (i) gaps in knowledge around implementation; (ii) which healthcare professionals (HCPs) deliver Seeking Safety; (iii) knowledge and training required to deliver it; and (iv) the experience of individuals completing Seeking Safety treatment. Methods A scoping review methodology was used to identify qualitative, quantitative, and grey literature of Seeking Safety as a treatment modality in individuals with PTSD and SUD. Results A total of 451 studies were identified. Following deduplications, 431 records were screened for inclusion, the full-text of 24 articles were reviewed for eligibility and 18 were included in the review. Extracted data was synthesized and six overarching themes were identified: (i) Seeking Safety as a treatment; (ii) meeting the needs of a diverse patient population group; (iii) factors impacting success; (iv) empowerment of self and agency over life; (v) measuring treatment success; and (vi) knowledge gaps of Seeking Safety treatment. Conclusion This scoping review considers the gaps in knowledge around Seeking Safety, specifically relating to which HCPs are best suited to delivering it in clinical practice; the knowledge and training required to deliver it; and the experience of individuals undertaking Seeking Safety.