Safe Coping When Trauma and Substance Use Overlap
An integrated trauma and substance use worksheet linking trauma reactions to urges, previous coping and safer alternatives, with a weekly commitment.
1-page fillable PDF · US Letter (prints on A4) · Integrated trauma and addiction
- Approach / concern
- Trauma & PTSD
- Technique
- Integrated trauma and addiction
- Format
- Fillable PDF, 1 page (US Letter / A4)
- Access
- Pro and Advanced plans (3-day free trial)
- For
- Licensed clinicians to use with clients
- Updated
- October 2026
Key facts
What is the Safe Coping When Trauma and Substance Use Overlap?
PTSD and substance use disorders frequently co-occur, often through self-medication. Integrated approaches address both, emphasizing safety and coping skills.
Why it works
Seeking Safety is a present-focused integrated treatment for PTSD and substance use (Najavits, 2002). Guidelines support treating PTSD in the presence of substance use (ISTSS, 2019).
When to use it
- Co-occurring PTSD and substance use
- Addiction treatment settings
- Early recovery
- Harm reduction
How to use it in session
- Link reactions to urges.
- Record past coping.
- Choose safer options.
- Commit to one step.
- Review weekly.
Clinician tips
- Avoid shaming substance use.
- Assess safety and withdrawal risk.
- Coordinate care.
Worked example
Sharing with clients
Members can download the PDF to print or email, or copy a private client link from the download box. Your client opens the link and downloads the worksheet on any device. No client account is needed, and nothing your client writes is stored on TherapyAid.
Frequently asked questions
Do I need to stop using before trauma therapy?
Not always. Integrated treatment can address both at the same time.
What is safe coping?
Ways of handling distress that don’t cause further harm.
References
Najavits, L. M. (2002). Seeking safety: A treatment manual for PTSD and substance abuse. Guilford Press.
International Society for Traumatic Stress Studies. (2019). ISTSS PTSD prevention and treatment guidelines: Methodology and recommendations. ISTSS.
This worksheet is an educational tool for use by, or under the guidance of, a licensed or registered mental-health professional. It is not a diagnostic instrument or a substitute for clinical judgement. If a client is in crisis in Canada, call or text 9-8-8 or call 9-1-1.
