Seeking Safety

Seeking Safety

Seeking Safety

Seeking Safety is an evidence-based, present-focused counseling model to help people attain safety from trauma and/or substance abuse. Seeking Safety is an extremely safe treatment model as it directly addresses both trauma and addiction, but without requiring clients to delve into the trauma narrative. It can be conducted in a group (any size) and/or individual modality. Seeking Safety was developed in 1992 by Lisa M. Najavits, PhD at Harvard Medical School and McLean Hospital. Since then, it has been used in many countries and has been translated into numerous languages.

Gabriella Grant is a senior trainer for Treatment Innovations, the organization created by Dr. Najavits to support treatment models including Seeking Safety. Gabriella started working with Dr. Najavits in 2006, when she oversaw a statewide project in California to increase access to domestic violence shelters by women with mental health and/or substance abuse issues. She coordinated the trainings on Seeking Safety and helped guide and evaluate its implementation within domestic violence shelters. Currently, Gabriella conducts Seeking Safety groups at a community level through the California Center of Excellence for Trauma Informed Care.

The Center has a long history of providing drop-in Seeking Safety groups in Santa Cruz for women dealing with domestic violence and/or substance abuse. From March 2020 to October 2020, the Center also provided a free online Seeking Safety group for healthcare practitioners. The Center works with partner agencies to provide Seeking Safety groups in the local community. If you or your agency are interested in working collaboratively with the Center regarding Seeking Safety, please contact the Center via traumainformedcalifornia@gmail.com or call us at 831-607-9835.

UBI Survey Tool

UBI Survey Tool

Unsafe Behaviors Inventory (UBI) Pilot Study

A key principle of trauma-informed care is recognizing the importance of improved safety. But how can we measure improved safety as a treatment outcome? Would you like to join an effort to develop a tool to measure unsafe behaviors and help to measure how effective a variety of treatments are in reducing unsafe behaviors?

The California Center of Excellence for Trauma Informed Care is beginning a pilot study to validate the Unsafe Behaviors Inventory to help programs focus more specifically on unsafe behavior reduction as a means of providing trauma-informed care.

Using the Unsafe Behaviors Inventory

What Is the UBI?

The Unsafe Behaviors Inventory (UBI) is a tool designed by the California Center of Excellence for Trauma-Informed Care (CCETIC) to measure reductions in unsafe behaviors. Administered at the beginning of a client’s participation in trauma-informed supports (“T1”), and again in 8–12 weeks (“T2”), the UBI helps treatment providers and clients themselves to recognize reductions in risky or destructive behaviors. There is an adult version of the UBI (UBI-A) and a youth version (UBI-Y).

Who should use the UBI?

The UBI should be used by treatment providers delivering trauma-informed, safety-focused, and skill-building services and supports, especially if they believe that those services and supports are likely to result in changes in client behavior over time. Treatment programs need not be clinical, but they should be trauma-informed. We recommend that the pre and post assessments be administered approximately 8–12 weeks apart, with the pre-assessment administered just as treatment is beginning.

Is the UBI Validated?

The UBI has not yet been validated. CCETIC is in the process of validating the tool. The only way you can currently use the UBI is to participate in the validation study.

I Want to Use the UBI: What Should I Do?

The UBI-Y and UBI-A are available for use with no cost or licensing fee. However, since the UBI is currently in the process of being validated, treatment providers must agree to participate in the validation study in order to use the tool with clients.

If you are a treatment provider and you want to use the tool, please go to the online provider agreement and read through the terms. All treatment providers participating in the UBI Validation Study will be asked to obtain informed consent with every client. The consent forms can be found below (note: for minors, informed consent is a two-step process). Once consent is obtained, treatment providers should administer a baseline assessment (T1). After administering the baseline UBI assessment, providers must complete a brief Provider Input questionnaire. This should only take 5–10 minutes, and gives treatment providers an opportunity to reflect and report on client and provider reactions to the UBI. After 8–12 weeks of treatment (Tx), providers should re-administer the UBI (T2). Providers may provide additional feedback if they so choose.

How Do I Administer the UBI?

Once treatment providers have completed the agreement to participate in the UBI Validation Study, they will have access to the links for the UBI-A and UBI-Y, which are exclusively available online. It can be self-administered by clients or administered by a treatment provider. Clients’ confidentiality is protected through an identification code system that enables us to track client changes without the use of client names. Depending on each client’s reading fluency and learning differences, the time required to take the UBI may range from 10 minutes to 30 minutes.

Will We Know the Results of Our Clients’ UBIs?

When a client or treatment provider completes a UBI, the results from the assessment will appear on the screen. Providers may print or save these results as a PDF for comparison with previous or future UBI results. These results will show responses to each question as well as a numerical score which represents the level of risk/unsafe behavior (the higher the number, the more unsafe the behavior). When interpreting the numbers, it is important to note any questions that were skipped, as the number of questions skipped should be subtracted from the total possible score (the tool will not automatically do this).

If treatment providers would like a full report of their program’s aggregate results, they may enter into an agreement with CCETIC who can produce reports at the program or agency level, or more nuanced reports that consider pre-post differences disaggregated by race, gender, or other variables.

We Are Ready to Use the UBI: What Do We Do Next?

For any questions or comments, email traumainformedcalifornia@gmail.com

The History of the UBI

The Unsafe Behaviors Inventory (UBI) began back in 2011, when clients in a group treatment benefited from a list of unsafe behaviors. I started “collecting” them: every time I heard of a new one, I wrote it down. As the list grew longer, clients said, ” I didn’t know that was unsafe!” or sometimes “I did not realize how safe I actually am!”. With the help of the 2012 Amherst College summer Intern Sharleen Phillips and several subsequent summer interns, it became clear that the tool was very helpful and easy to use. However, to do a study to validate…

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Measuring Improved Safety

The Unsafe Behaviors Inventory (UBI) asks clients to self-report how often they are currently engaging in various unsafe behaviors (e.g., fighting, overeating, using substances, etc). There are 66 behaviors listed in total, including an additional field for clients to describe other behaviors they consider unsafe. Clients use a scale (see Figure 1) to indicate the frequency of each behavior, ranging from “Never” (scored as 0) to “Several times a day” (scored as 12). When the client completes the UBI online, a cumulative “score” is automatically generated, summing all of the client’s responses. The lowest possible score on the tool is…

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Provider Follow-Up Data: Reflections on the UBI

Being asked about their trauma histories has the potential to create negative reactions among clients (SAMHSA, 2014a). Treatment providers are, therefore, sometimes apprehensive to administer assessments that ask clients about trauma histories (SAMHSA, 2014b). What’s different about the UBI is that it focuses on current behavior—what clients are doing these days, rather than what has happened to them in the past. In this way, it can provoke less anxiety than many of the tools used in treatment, for both client and treatment provider.

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Demographics of the UBI

Demographic questions ask about the characteristics of human populations, including gender & sex, age, race & ethnicity, geography, and income. In research, demographic questions are oftentimes an important and integral part of the study and data. However, there is a risk to both the participant and the data in asking demographic questions. Asking about demographics can feel triggering to the participant making them feel unsafe, which is why questions need to be framed in a culturally sensitive way and asked at the right time.

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White Papers and Guides

White Papers and Guides

White Papers

Sexual Assault Revictimization Risk Reduction

Sexual Assault Risk Reduction

The purpose of this white paper is to make a sober appraisal of the risk factors that increase the likelihood of a survivor of sexual assault being reassaulted. This white paper provides recommendations to sexual assault victim services for more effectively reducing known risk factors that place victims in danger of being sexually assaulted again. It focuses on delivering researched, informed, thought-out, policy-based guidelines for action specifically on the individual level.

Read the full PDF white paper

Spirituality and Trauma Recovery

The California Center of Excellence for Trauma Informed Care has produced the following white paper in coordination with its website project to help Stop Trusted Advisor Abuse by providing an opportunity to educate the general public, to hold professionals to a higher level of responsibility, to ensure that accountability systems do a much better job policing abuse within their ranks, and to protect those who rely on providers, whether in publicly-funded systems or on the private market.

Read the full PDF white paper

Trauma and Opioid Misuse and Treatment

In light of the frequent connection between trauma exposure and substance abuse, the California Center of Excellence for Trauma Informed Care has produced the following white paper as part of its mission to advance research-based policies and practices that respond to the needs of trauma-exposed clients by focusing on safety, skills and designing practices that encourage trauma recovery.

Read the full PDF white paper

Introductions to Trauma Informed Key Values

Introduction: Key Values Begin with Safety

Founded in 2009, the California Center of Excellence for Trauma Informed Care is an organization dedicated to helping publicly funded agencies understand the impact of trauma on their clients, both individually and as a group, and to then use that understanding to design programs (interventions, policies, training) to work more effectively with their clients. Using the Fallot and Harris (2001) framework from “Using Trauma Theory to Design Service Systems” as the foundation from which to then build and strengthen the entire publicly funded social service system. Fallot identifies key values from which a trauma-informed program can develop: safety, trustworthiness, choice,…

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Who are trauma informed services for?

A recent publication on creating trauma informed programs for sexual assault programs (available for download on the Resources page), quoted the National Center for Trauma-Informed Care, “Trauma-informed care is an approach to engaging people with histories of trauma that recognizes the presence of trauma symptoms and acknowledges the role that trauma has played in their lives.”
This is a key definition to our understanding of trauma informed care as it relates to service provision. For too long and with dire consequences, mental health, substance abuse, domestic violence, child abuse intervention, hospitals, and schools—among others—simply saw challenging and unproductive behavior as…

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What’s wrong with relationships?

“Children develop within an environment of relationships that begins in the family but also involves other adults who play important roles in their lives. This can include extended family members, providers of early care and education, nurses, social workers, coaches, and neighbors,” states the Center on the Developing Child at Harvard University in From Best Practices to Breakthrough Impacts: A Science-Based Approach to Building a More Promising Future for Young Children and Families (2016). The seemingly benign statement is fraught with potentially negative results.

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Links to Topical PDF Guides and Bibliographies

Practicing Self Care at the Utah Trauma Academy
Trauma and Opioids Misuse & Treatment Bibliography
Helping Homeless Persons Find Shelter and Services
Trauma Informed Solutions to Sheltering and Housing Bibliography
Quick Start Guide to Talking Eating Disorders
Trauma, Food and the Body Bibliography
Our Human Needs Checklist
8 Things to Do to Become More Creative & Insightful
Start Your Own Sleep Makeover
Trauma Informed Schools
About the Center

About the Center

About the Center

Founded in 2009 and originally located within the Walnut Avenue Family and Women’s Center in Santa Cruz, the California Center of Excellence for Trauma Informed Care (CCETIC) promotes trauma-informed practices within California’s social service sector. The Center works to achieve this goal through the creation of informative, research-based white papers and guides, the Unsafe Behaviors Inventory pilot study, and the Stop Trusted Advisor Abuse public advocacy campaign.

Learn More

Unsafe Behaviors Inventory (UBI)

The Unsafe Behaviors Inventory (UBI) is a survey created by the Center to measure reductions in unsafe behaviors over time. The UBI tool is designed to be used by treatment providers delivering trauma-informed, safety-focused, and skill-building services and supports. Agencies or individuals interested in the study can find more detailed information on our UBI Survey page. 

The Center also provides direct services. Since November 2009, CCETIC director Gabriella Grant has offered no-cost drop-in Seeking Safety groups for women in downtown Santa Cruz.  Originally hosted by the Walnut Avenue Family and Women’s Center and then Siena House, the groups have offered accessible, affordable, and effective treatment for over 800 women. Seeking Safety is a collaborative effort between the Center and partner agencies. Agencies interested in hosting Seeking Safety groups can contact traumainformedcalifornia@gmail.com or visit our Seeking Safety page for more information.

As director of the California Center of Excellence for Trauma Informed Care, Gabriella Grant oversees the Center’s research, program and professional development, and policy analysis activities. Her background includes heading the nation’s first community-corrections-based victim advocacy program and running a three-year project funded by the California Department of Public Health to increase access to domestic violence shelters by women with mental health and/or substance abuse issues. The domestic violence shelter project showed that it is possible to increase capacity to serve women with co-occurring disorders by understanding trauma and developing programs that respond to people’s need for safety.

Our Mission

The mission of the California Center of Excellence for Trauma Informed Care is to transform publicly funded programs and systems by strengthening their understanding of the broad effects of trauma and increasing safety in behavior, lives, and communities in California and across the nation.

The Center is focusing its efforts on providing high quality research and education for the public. Currently, the Center is working on creating individual-level certification courses on trauma-informed care and stopping trusted advisor abuse. For more information, contact traumainformedcalifornia@gmail.com. 

To give a tax-deductible donation to the California Center of Excellence for Trauma Informed Care, please contact Gabriella Grant at 831-515-7570.

Resources

Resources

Below are some resource documents and links that may be helpful to agencies that are working to become more trauma-informed.

Presentations and Explainers

Resource Documents