1st Edition

Creating Change A Past-Focused Treatment for Trauma and Addiction

By Lisa M. Najavits Copyright 2024

    This flexible, evidence-based manual offers counselors a gentle, compassionate approach to help people with trauma, addiction, or both explore their past. Creating Change guides clients to understand how trauma and addiction arose over time, grieve losses and regrets, create a new perspective on their life story, and take pride in their survival. The manual has 23 topics that can be implemented in any order with individuals or groups. Topics include Relationship Patterns, Break the Silence, Deepen Your Story, Darkness and Light, Emotions and Healing, and Influences: Family, Community, Culture. Creating Change can be implemented with any other treatment, including the author’s present-focused model, Seeking Safety. The book has a convenient large-size format and includes 70 reproducible handouts, many of which can be downloaded and printed at the companion website.

    See also Seeking Safety: A Treatment Manual for PTSD and Substance Abuse, and the self-help guide Finding Your Best Self, Revised Edition: Recovery from Addiction, Trauma, or Both, an ideal client recommendation.

    1. Overview of Creating Change
    2. The Larger Context
    3. How to Conduct Creating Change
    4. The Counselor
    Treatment Topics
    - Introduction
    - Create Change
    - Trust versus Doubt
    - Honor Your Survival
    - Relationship Patterns
    - Why Addiction?
    - Respect Your Defenses
    - Break the Silence
    - Darkness and Light
    - Emotions and Healing
    - Tell Your Story
    - Influences: Family, Community, Culture
    - Knowing and Not Knowing
    - Your Personal Truth
    - What You Want People to Understand
    - Listen to Your Body
    - Memory
    - Power Dynamics
    - Deepen Your Story
    - Growth
    - Extra Topic: Understanding Trauma and Addiction
    - Extra Topic: Recovery Strengths and Challenges
    - Extra Topic: Your Relationships
    Appendix A. Key Terms
    Appendix B. Comparison of All Models Studied for PTSD/SUD
    Appendix C. Comparison of Models by the Author


    Lisa M. Najavits, PhD, is Adjunct Professor at the University of Massachusetts Chan Medical School and Director of Treatment Innovations. She was on the faculty of Harvard Medical School (McLean Hospital) for 25 years and Boston University School of Medicine (Veterans Affairs Boston) for 12 years. Dr. Najavits specializes in the development of new counseling models for trauma and addiction, clinical trials research, and community-based care. She is author of over 200 publications, including the books Seeking Safety: A Treatment Manual for PTSD and Substance Abuse; Finding Your Best Self: Recovery from Addiction, Trauma, or Both; A Woman's Addiction Workbook; and Creating Change: A Past-Focused Treatment for Trauma and Addiction. She has served as president of the Society of Addiction Psychology of the American Psychological Association and has consulted widely on public health efforts in trauma and addiction, both nationally and internationally. She is a recipient of the Young Professional Award from the International Society for Traumatic Stress Studies, the Early Career Contribution Award from the Society for Psychotherapy Research, the Emerging Leadership Award from the Committee on Women in Psychology of the American Psychological Association, the Betty Ford Award from the Association for Multidisciplinary Education and Research in Substance Use and Addiction, and the Distinguished Alumna Award from Barnard College. Dr. Najavits is a licensed psychologist in Massachusetts and conducts a psychotherapy practice.

    "Among the many virtues of Creating Change, perhaps the greatest is that it takes a public health approach to two major problems that are often intertwined--trauma and addiction. With a simple but adaptable structure, this approach makes treatment accessible and affordable to a wide population, with very few restrictions on who is eligible for care or who can serve as a counselor. Unlike many manualized treatment models that impose a rigid, 'one-size-fits-all' template, Creating Change offers patients maximum flexibility and choice. For survivors who have suffered the humiliations of stigma and powerlessness, this model is based on the principles of compassion, respect, and empowerment."--Judith Lewis Herman, MD, Department of Psychiatry, Harvard Medical School

    "Creating Change is a fresh, evidence-based, nonpathologizing approach to treatment of trauma and addiction. It offers a past-focused model that empowers the survivor to carefully process trauma memories while engaging resilience and growth. If you are one of Najavits's many thousands of professional and lay followers, you already know of her brilliant and incisive work. Well, prepare yourself for this one--Creating Change is guaranteed to be an instant classic."--John Briere, PhD, Department of Psychiatry and Behavioral Sciences (Emeritus), Keck School of Medicine, University of Southern California

    “Infused with clinical wisdom and practical guidance, Creating Change provides a kinder, gentler way to process trauma and recover from addiction. Najavits expertly details the rationale and research support for her unique perspective and describes critical relationship dimensions to effectively engage clients. The book presents essential science-based concepts that can be adapted to fit client and counselor. It offers 23 treatment topics that are relevant, interesting, and engaging. Each topic has a wealth of information, handouts, and activities to guide counselors and clients through important conversations about the past while preventing retraumatizing and triggering. Counselors and trainees will find all they need to implement the model to promote integrated, client-centered care and recovery.”--Carlo C. DiClemente, PhD, ABPP, Department of Psychology (Emeritus), University of Maryland, Baltimore County

    "This exceptional treatment manual for trauma and addiction stands out in the mental health literature. One of the book's strengths lies in its clear, concise descriptions and accessible language, which means that it can be used by all providers. Najavits breaks down relevant topics into easily understood instructions that work very well clinically. Each chapter is meticulously structured, providing a step-by-step guide to mastering the structure and content of the method. The broad definition of trauma and addiction in Creating Change makes it suitable for a wide range of vulnerable individuals. The flexible format that encourages session-to-session assessment of the client makes the approach very safe to use. I highly recommend this 'must-have' resource for counselors and therapists working with addiction or trauma."--Sidsel Karsberg, PhD, Center for Alcohol and Drug Research, University of Aarhus, Denmark-