Day Five


Vicarious traumatization (VT) is a transformation in the self of a trauma worker or helper that results from empathic engagement with traumatized clients and their reports of traumatic experiences. It is a special form of countertransference stimulated by exposure to the client's traumatic material.

Agenda - Day Five

9:00 – 10:00

Opening Prayers, Drumming and Thanks

“What do you need” Exercise and Making of Intentions

Grounding, Centering and Focusing


10:00 – 11:00

Introduction to Vicarious Traumatization

Theoretical Underpinnings

11:00 – 11:15


11:15 – 12:15 PM

Internalised Oppression Explored: Multiple Loss


12:15 – 1:00


1:00 – 2:00


Introduction to Loss, Grief & Bereavement

2:00 – 2:30

Transforming the Therapist

2:30 – 2:45


2:45 – 3:45

Create your own self-care and future – experiential

Vicarious Transformation

3:45 – 4:00

Moving Forward / Closing Remarks


How do we best accompany those seeking care into this realm within and below the body?  The shadow region, named “distressing: sick at heart.”  There is only one way.  We must go there ourselves.

Saki Santorelli :  Author of Heal Thyself

The aim of this presentation is to explore the pervasive effects of vicarious trauma on the mind, body, psyche and spirit of the health-care provider. Vicarious Trauma, being the transformation of the self of the worker that comes about from the empathic engagement with traumatized clients will be explored.  Participants will learn about the contributing factors, the related concepts, signs and symptoms, and mechanisms of vicarious trauma. The workshop will move beyond vicarious trauma to the exploration of vicarious transformation and it components.  Participants will experience first hand the ancient concepts of transformation, mindfulness and healing that ultimately lead to deep spiritual growth.

Learning Objectives: 

  • Identify and understand the pervasive effects of vicarious trauma on the workers identity, world view, psychological needs, beliefs and memory system

  • Understand that the hallmark of vicarious trauma is disrupted spirituality, meaning or hope and that it affects a wide range of persons who assist trauma survivors

  • Discuss and identify the mechanism of vicarious trauma, which is empathy and compassion for self and others

  • Explore experientially various coping strategies that move suffering to healing through embracing awareness, balance and connection

  • Move beyond vicarious trauma and embrace vicarious transformation, the process of transforming vicarious trauma into spiritual growth and internal transformation

About Compassion

Compassion is not just about feeling the pain of others; it’s about bringing of them in toward yourself. If we love what Creator loves, then, in compassion margins get erased.

 “Be compassionate as Creator is compassionate.” Means the dismantling of barriers that exclude.

Gregory Boyle, founder of Homeboy Industries

Compassion stone

The Seven Grandfather Teachings

Among the Anishinaabe people, the Teachings of the Seven Grandfathers, also known simply as either the Seven Teachings or Seven Grandfathers, is a set of teachings on human conduct towards others. These were originally published in Edward Benton-Banai’s book The Mishomis Book. The following is an example of a contemporary Anishinaabe teaching presented in the form of a traditional teaching. These are used in contemporary situations.

  • Nibwaakaawin – Wisdom: To cherish knowledge is to know Wisdom. Wisdom is given by the Creator to be used for the good of the people. In the Anishinaabe language, this word expresses not only wisdom, but also means prudence, or intelligence. In some communities, the word Gikendaasowin is used; in addition to wisdom, this word can also mean intelligence or knowledge.
  • Zaagi'idiwin – Love: To know Love is to know peace. Love must be unconditional. When people are weak they need love the most. In the Anishinaabe language, this word with the reciprocal theme /idi/ indicates that this form of love is mutual. In some communities, the word Gizhaawenidiwin is used, which in most context means jealousy but in this context is translated as either love or zeal. Again, the reciprocal theme /idi/ indicates that this form of love is mutual.

  • Minaadendamowin – Respect: To honor all creation is to have Respect. All of creation should be treated with respect. You must give respect if you wish to be respected. Some communities use the words Ozhibwaadenindiwin or Manazoonidiwin.

  • Aakode'ewin – Bravery: Bravery is to face the foe with integrity. In the Anishinaabe language, this word literally means state of having a fearless heart, to do what is right even when the consequences are unpleasant. Some communities instead use either Zoongadikiwin that means, state of having a strong casing, or Zoongide'ewin, that means, state of having a strong heart.

  • Gwayakwaadiziwin – Honesty: Honesty in facing a situation is to be brave. Always be honest in word and action. Be honest first with yourself, and you will more easily be able to be honest with others. In the Anishinaabe language, this word can also mean righteousness.

  • Dabaadendiziwin – Humility: Humility is to know yourself to be a sacred part of Creation. In the Anishinaabe language, this word can also mean compassion. You are equal to others, but you are not better. Some communities instead express this with the word Bekaadiziwin, which in addition to humility can also be translated as calmness, meekness, gentility or patience.

  • Debwewin – Truth: Truth is to know all of these teachings. Speak the truth. Do not deceive yourself or others.

Adapted from: Benton-Banai, E. (1988). The Mishomis Book: The Voice of the Ojibway. Hayward, WI: Indian Country Communications.


References & Interesting Papers

Abdullah, J. & Stringer, E. (1999). Indigenous knowledge, Indigenous learning, Indigenous research. In L. Semali & J. L. Kincheloe (Eds.), What is Indigenous Knowledge? Voices from the Academy (pp. 205–222). New York, NY: Falmer Press.

Aboriginal Healing Foundation. (2005). Reclaiming connections: Understanding residential school trauma among Aboriginal people. Ottawa, Canada: Author.

Aboriginal Healing Foundation. (2007). Addictive behaviours among Aboriginal people in Canada. Ottawa, Canada: Deborah Chansonneuve.

Absolon, K. E. & Willett, C. (2004). Aboriginal research: Berry picking and hunting in the 21st century. First Peoples Child & Family Review, 1(1), 5–17.

Assembly of First Nations. (1994). Breaking the silence: An interpretive study of residential school impact and healing as illustrated by the stories of First Nation individuals. Ottawa, Ontario, Canada: Author.

Barrett, E. L., Indig, D., Sunjic, S., Sannibale, C., Sindicich, N., Rosefeld, J., Najavits, L.M.,   & Mills, K, (2015). Treating comorbid substance use and traumatic stress among male     prisoners: a pilot study of the acceptability, feasibility, and     preliminary efficacy of Seeking Safety. International Journal of Forensic Mental Health, 14, 45–55.

Bartlett, C. M. (2009). Mother earth, grandfather sun. Green Teacher, 86, 29-32.

Bartlett, C. (2009, February). Introduction to integrative science and Two-Eyed Seeing. Pedagogical practices: Re-thinking the worlds of teaching. Presentation from a conference conducted on teacher education at Simon Fraser University, Surrey, BC.

Bartlett, C., Marshall, M., & Marshall, A. (2012). Two-Eyed Seeing and other lessons learned within a co-learning journey of bringing together indigenous and mainstream knowledges and ways of knowing. Journal of Environmental Studies and Sciences, 2, 331-340. Doi: 10.1007/s13412-012-0086-8

Battiste, M. (Ed.). (2000). Reclaiming Indigenous voice and vision. Vancouver, BC: UBC Press.

Brave Heart, M. Y. H. (2003). The historical trauma response among Natives and its relationship with substance abuse: A Lakota illustration. Journal of Psychoactive Drugs, 35(1), 7–13. doi:10.1080/02791072.2003.10399988

Brave Heart-Jordan, M. Y. H. (1995). The return to the sacred path: Healing from historical trauma and historical unresolved grief among the Lakota. Unpublished doctoral dissertation. Smith College School of Social Work. Northampton, MA.

Brave Heart, M. Y. H. (1998). The return to the sacred path: Healing the historical trauma and historical unresolved grief response among the Lakota through a psychoeducational group intervention. Smith College Studies in Social Work, 68(3), 287-305.

Brave Heart, M. Y. H. (1999). Gender differences in the historical trauma response among the Lakota. Journal of Health and Social Policy, 10(4), 1-21.

Brave Heart, M. Y. H. (2004). The historical trauma response among Natives and its relationship to substance abuse: A Lakota illustration. In E. Nebelkopf & M. Phillips (Eds.), Healing and mental health for Native Americans: Speaking in red (pp. 7-18). Lanham, MD: AltaMira Press.

Bombay, A., Matheson, K., & Anisman, H. (2009). Intergenerational trauma: Convergence of multiple processes among First Nations peoples in Canada. Journal of Aboriginal Health, 5(3), 6–47.

Briere, J. & Scott, C. (2006) Principles of trauma therapy: A guide to symptoms, evaluation, and treatment. Thousand Oaks CA: Sage Publications.

Canadian Institutes of Health Research. (2011). Knowledge translation strategy 2004-2009: Innovation in action. Retrieved from

Canadian Institutes of Health Research. (2011). Guidelines for research involving Aboriginal people. Retrieved from

Chansonneuve, D. (2007). Addictive behaviours among Aboriginal people in Canada. Ottawa, Canada: Aboriginal Healing Foundation.

Chandler, M. J., & Lalonde, C. (1998). Cultural continuity as a hedge against suicide in Canada’s First Nations. Transcultural Psychiatry. 35(2), 191-219.

Chilcoat, H. D., & Menard, C. (2003). Epidemiological investigations: Comorbidity of posttraumatic stress disorder and substance use disorder. In P. J. Brown (Ed.), Trauma and substance abuse: Causes, consequences, and treatment of comorbid disorders (pp. 9–28). Washington, DC: American Psychological Association.

Cook, J. M., Walser, R. D., Kane, V., Ruzek, J. I., & Woody, G. (2006). Dissemination and feasibility of a cognitive-behavioral treatment for substance use disorders and posttraumatic stress disorder in the Veterans Administration. Journal of  Psychoactive Drugs, 38, 89–92.

Corrado, R. R., & Cohen, I. M. (2003). Mental health profiles for a sample of British Columbia’s Aboriginal survivors of the Canadian residential school system. Ottawa, Canada: Aboriginal Healing Foundation.

Cote, H., & Schissel, W. (2008). Damaged children and broken spirits: A residential school survivor story. In Brooks, C. & Schissel, B. (Eds.), Marginality & condemnation: An introduction to critical criminology (2nd edition, pp. 220-237). Black Point, NS: Fernwood Publishing.

Courtois, C. A. & Ford, J. D. (Eds.) (2009). Treating complex traumatic stress disorders. New York: Guilford.

Crazy Bull, C. (1997a). Advice for the non-Native researcher. Tribal College Journal of American Indian Higher Education 9 (24), 26-39.

Chrisjohn, R. & Young, S. (1997). The circle game: Shadows and substance in the Indian residential school experience in Canada. Penticton, British Columbia, Canada: Theytus Books.

Danieli, Y. (1989). Mourning in survivors and children of survivors of the Nazi Holocaust: The role of group and community modalities. In D. R. Dietrich & P. C. Shabad (Eds.), The problem of loss and mourning: Psychoanalytic perspectives (pp. 427-457). Madison, CT: International Universities Press.

Desai, M. M., Harpaz-Rotem, I., Najavits, L. M., & Rosenheck, R. A. (2008). Impact of the Seeking Safety program on clinical outcomes among homeless female veterans with psychiatric disorders. Psychiatric Services, 59(9), 996–1003.

Drake, A. (2003). Healing of the soul: Shamanism and psyche. New York, NY: Busca,Inc. 

Duran, E. (2006). Healing the soul wound: Counseling with American Indians and other Native peoples. New York, NY: Teacher’s College.

Duran, E. & Duran, B. (1995). Native American postcolonial psychology. Albany, NY: State University of New York. Erikson, E. (1963). Childhood and society (Rev. ed). New York, NY: W.W Norton.

Evans-Campbell, T. (2008). Historical trauma in American Indian/Native Alaskan communities: A multilevel framework for exploring impacts on individuals, families, and communities. Journal of Interpersonal Violence, 23(3), 316-338.

Fogelman, E. (1991). Mourning without graves. In A. Medvene (Ed.), Storms and rainbows: The many faces of death (pp. 25-43). Washington, DC: Lewis Press.

Gagne, M. (1998). The role of dependency and colonialism in generating trauma in First Nations citizens. In Y. Danieli (Ed.), International handbook of multigenerational legacies of trauma (pp. 355-372). New York, NY: Plenum Press.

Gatz, M., Brown, V., Hennigan, K., Rechberger, E., O’Keefe, M., Rose, T., & Bjelejac,

  1. (2007). Effectiveness of an integrated trauma-informed approach to treating  women with co-occurring disorders and histories of trauma. Journal of Community Psychology, 35, 863–878.

Goforth, S. (2007). Aboriginal healing methods for residential school abuse and intergenerational effects: A review of the literature. Native Social Work Journal: Resistance and Resiliency: Addressing historical trauma of Aboriginal peoples, 6,1, 11-32.

Gone, J. P. (2008). The Pisimweyapiy Counselling Centre: Paving the Red Road to Wellness in Northern Manitoba. Aboriginal Healing in Canada: Studies in Therapeutic Meaning and Practice. In J. B. Waldram (Ed.), Aboriginal healing in Canada: Studies in therapeutic meaning and practice (pp. 131–204). Ottawa, ON, Canada: Aboriginal Healing Foundation.

Gone, J. P. (2009). A community-based treatment for Native American historical trauma: Prospects for evidence-based practice. Journal of Consulting and Clinical Psychology, 77, 751–762.

Grant, A. (1996). No end of grief: Indian residential schools in Canada. Ontario: Pemmican Publications Inc.

Harper, S. (2008). Statement of apology - to former students of Indian residential schools. Ottawa, ON: Government of Canada.

Hart, M. A. (2010). Indigenous worldviews, knowledge, and research: The development of an Indigenous research paradigm. Journal of Indigenous Voices in Social Work, 1, 1-16.

Haskell, L. (2003). First stage trauma treatment: A guide for mental health professionals working with women. Toronto, Canada: Centre for Addiction and Mental Health.

Haskell, L., & Randall, M. (2009). Disrupted attachments: A social context trauma framework and the lives of Aboriginal people in Canada. Journal of Aboriginal Health, 5(3), 48–99.

Health Canada (2003). A Statistical Profile on the Health of First Nations in Canada. Ottawa, ON: Health Canada, First Nations and Inuit Health Branch.

Hien, D. A., Cohen, L. R., Litt, L. C., Miele, G. M., & Capstick, C. (2004). Promising empirically supported treatments for women with comorbid PTSD and substance use disorders. American Journal of Psychiatry, 161, 1426–1432.

Hien, D. A., Jiang, H., Campbell, A. N., Hu, M. C., Miele, G. M., Cohen, L. R., . . .Nunes, E. V. (2010). Do treatment Improvements in PTSD severity affect substance use     outcomes? A secondary analysis from a randomized clinical trial in NIDA’s Clinical Trials’s Network. American Journal of Psychiatry, 167(1), 95–101.

Hien, D. A., Campbell, A. N, Ruglass, L. M., Hu, M. C., Killeen, T. (2010, a). The role of alcohol misuse in PTSD outcomes for women in community treatment: a secondary analysis of NIDA’s Women and Trauma Study. Drug and Alcohol Dependence, 111,1-2, 114-119.

Hien, D. A., Wells, E. A., Jiang, H., Suarez-Morales, L., Campbell, A., Cohen, L., Miele, G., Killeen, T., Brighman, G., Zhang, Y., Hansen, C., Hodgkins, C., Hatch-Maillette, M., Brown, C., Kulaga, A., Kristman-Valente, A., Chu, M., Sage, R., Robinson. J., Liu, D., & Nunes, E.V.  (2009). Multi-site randomized trial of behavioral interventions (2009). Multi-site randomized trial of behavioral interventions for women with co-occurring PTSD and substance use disorders. Journal of Consulting and Clinical Psychology. 77(4), 607-619.

Hien, D. A., Levin, F. R., Ruglass, L. M., López-Castro, T., Papini, S., Hu, M.C., Cohen, L. R., & Herron, A. (2015). Combining Seeking Safety with Sertraline for PTSD and alcohol use disorders: A randomized controlled trial. Journal of Consulting and Clinical Psychology. Advance online publication.

Herman, L. H. (1992). Trauma and recovery. New York, NY: Harper Collins.

Herman, J. (1997). Trauma and recovery: The aftermath of violence, from domestic abuse to political terror (Rev. ed). New York, NY: Basic Books.

Herman, J. L. (2006). My life and work. In C. R. Figley (Ed.), Mapping the trauma and its wake: Autobiographic essays by pioneer trauma scholars (pp. 77-83). New York, NY: Routledge.

Hill, D. M. (2009). Traditional medicine and restoration of wellness strategies. Journal of Aboriginal Health, 5(1), 26–42. Retrieved from

Hodgson, M. (2008). Reconciliation: A spiritual process. In M. Brant Castellano, L. Archibald, & M. DeGagné (Eds.), From Truth to reconciliation: Transforming the legacy of residential schools (pp. 361-379). Ottawa, Ontario, Canada: Aboriginal Healing Foundation.

Hylton, J. H., Bird, N., Eddy, N., Sinclair, H., & Stenerson, H. (2002). Aboriginal sex offending in Canada. Ottawa, Ontario, Canada: Aboriginal Healing Foundation.

International Society for Traumatic Stress Studies Practice Guidelines (2009). Treatment

of PTSD with comorbid disorders: guideline 18. In: Foa, E.B., Keane, T.M.,Friedman, M.J., Cohen, J.A. (Eds.), Effective Treatments for PTSD (pp. 606-613) Guilford, New York.

Iwama, M., Marshall, A., Marshall, M., & Bartlett, C. (2009). Two-Eyed Seeing and the Language of Healing in Community-Based Research. Canadian Journal of Native Education, 32, 3–23.

Jiwa, A., Kelly, L., and Pierre-Hansen, S.N. (2008). Healing the community to heal the individual. Canadian Family Physician, 54(7), 1000–1000. e7.

Kawamoto, W. T. (2001) Community mental health and family issues in sociohistorical context: The Confederated Tribes of Coos, Lower Umpqua, and Siuslaw Indians. American Behavioral Scientist, 44(9),  1482-1491.

Kirmayer, L. J., Brass, G. M., & Tait, C. L. (2000). The mental health of aboriginal peoples: Transformations of identity and community. Canadian Journal of Psychiatry, 45, 607-616.

Kirmayer, L. J., Tait, C. L., & Simpson, C. (2009). The mental health of Aboriginal peoples in Canada: Transformations of identity and community. In L. J. Kirmayer & G. G. Valaskakis (Eds.), Healing traditions: The mental health of Aboriginal peoples in Canada (pp. 3–35). Vancouver, Canada: University of British Columbia.

Kovach, M. (2009). Indigenous methodologies: Characteristics, conversations, and contexts. Toronto, Canada: University of Toronto Press.

Krystal, H. (1984). Integration & self-healing in post-traumatic states. In S. A. Luel & P. Marcus (Eds.), Psychoanalytic reflections of the Holocaust: Selected essays (pp. 113–134). New York, NY: University of Denver (Colorado) and Ktav Publishing House.

Lavallée, L. (2009). Balancing the Medicine Wheel through physical activity. Journal of Aboriginal Health, 4(1), 64–71.

Lavallée, L. (2007a). Threads of connection: Addressing historic trauma of indigenous people through cultural recreational programming. Doctoral dissertation, University of Toronto, Canada. Retrieved Jan 2, 2011, from Dissertations & Theses:  Full Text database. (Publication No. AAT NR28105).

Lenz, A. S., Henesy, R., & Callender, K. (2016).  Effectiveness of Seeking Safety for Co-  Occurring Posttraumatic Stress Disorder and Substance Use. Journal of Counseling &  Development, 94, 51-61.

Liamputtong, P. (2010). Cross-cultural research and qualitative inquiry. Turkish Online Journal of Qualitative Inquiry, 1(1),  16-29.

Linklater, R. (2010). Decolonizing our Spirits: Cultural knowledge and Indigenous healing. In S. Marcos (Ed), Women and Indigenous religions (pp. 217–232). Santa Barbara, CA: Praeger.

Loppie-Reading, C. & Wien, F. (2009). Health inequalities and social determinants of Aboriginal Peoples' health. National Collaborating Centre for Aboriginal Health. Prince George, BC.

Marsh, T. N. (2010). Enlightenment is letting go! Healing from trauma, addiction, and multiple loss. Bloomington, IN: Authorhouse.

Marsh, T.N., Coholic, D., Cote-Meek, S., Najavits, L.M., (2015a). Blending Aboriginal and Western healing methods to treat intergenerational trauma with substance use disorder in Aboriginal peoples who live in northeastern Ontario Canada. Harm Reduction Journal, 12(1),  1-12.

Marsh, T.N., Cote-Meek, S., Toulouse, P., Najavits, L.M., Young, N.L., (2015b).   The      application of Two-Eyed Seeing decolonizing methodology in qualitative and quantitative research for the treatment of intergenerational trauma and substance use disorders. International Journal of Qualitative Methods, 14(4), 1-13.

Marsh, T.N., Cote-Meek, S., Young, N.L., Najavits, L.M., Toulouse, P., (2015c).   Indigenous healing and Seeking Safety: A blended implementation project for       intergenerational trauma and substance use disorders. The International Indigenous Policy Journal, 7(2) Retrieved from: ttp://           DOI: 10.18584/iipj.2016.7.2.3

Marsh, T.N., Young, N.L., Cote-Meek, S., Najavits, L.M., Toulouse, P., (2015d). Embracing Minobimaadizi, “living the good life”: healing from intergenerational trauma and substance use through Indigenous Healing and Seeking Safety. Journal of Addiction Research and Therapy, 7 (3), 284-294. doi:10.4172/2155-   05.1000284

McCormick, R. (2009). Aboriginal approaches to counselling. In L. J. Kirmayer & G. G. Valaskaki, (Eds.), Healing traditions: The mental health of aboriginal peoples in Canada (pp. 337-354). Vancouver, BC: University of British Columbia Press.

Mehl-Madrona, L. (2009). What traditional Indigenous Elders say about cross-cultural mental health training. Explore, 5(1),  20-29.

Menzies, P. (2004). Addiction and Aboriginal Healing. In S. Harrison & V. Carver (Eds.), Alcohol and drug problems. A practical guide for counsellors (3rd ed., pp. 455-481). Toronto, Ontario, Canada: Centre for Addiction and Mental Health.

Menzies, P., Bodnar, A., & Harper, V. (2010). The role of the Elder within a mainstream addiction and mental health hospital: Developing an integrated model. Native Social Work Journal, 7, 87-107.

Menzies, P. (2014). Intergenerational Trauma. In P. Menzies & L. Lavallée, (Eds.), Aboriginal

people with addiction and mental health issues: What health, social service and justice workers need to know (pp. 61-72). Toronto: CAMH Publications.

Milloy, J. (1996). A National Crime: The Canadian Government and the Residential

School System – 1879 to 1986. Winnipeg: University of Manitoba Press.

Minister of Supply and Services Canada (1996). Royal Commission on Aboriginal Peoples. Report. Vol 1. Ottawa, ON: Author.

Morrissey, J. P., Jackson, E. W., Ellis, A. R., Amaro, H., Brown, V. B., & Najavits, L. M. (2005). Twelve-month outcomes of trauma-informed interventions for women with co-occurring disorders. Psychiatric Services, 56, 1213–1222.

Mussell, W. J. (2005). Warrior-caregivers: Understanding the challenges and healing of First Nations men: A resource guide. Ottawa, Ontario, Canada: Aboriginal Healing Foundation.

Nabigon, H. (2006). The hollow tree: Fighting addiction with traditional native healing. Kingston, Canada: McGill Queen’s University Press.

Najavits, L. M., Weiss, R. D., Shaw, S. R., & Muenz, L. R. (1998). Seeking Safety: Outcome of a new cognitive–behavioral psychotherapy for women with posttraumatic   stress disorder and substance dependence. Journal of Traumatic   Stress, 11(3), 98–104.

Najavits, L. M. (2002a). Seeking Safety: A treatment manual for PTSD and substance abuse. New York, NY: Guilford.

Najavits, L. M. (2002b). Seeking Safety: Therapy for trauma and substance abuse. Corrections Today, 64, 136–140.

Najavits, L. M., Schmitz, S., Gotthardt, S., & Weiss, R. D. (2005). Seeking Safety plus exposure therapy for dual diagnosis in men. Journal of Psychoactive Drugs, 27,  425–435.

Najavits, L. M., Schmitz, S., Gotthardt, S., & Weiss, R. D. (2005). Seeking Safety plus exposure therapy for dual diagnosis in men. Journal of Psychoactive Drugs, 27, 425–435.

Najavits, L. M., Gallop, R. J., & Weiss, R. D. (2006). Seeking Safety: Therapy for adolescent girls with PTSD and substance abuse disorder: A randomized controlled trial. Journal of Behavioral Health Services & Research, 33, 453–463.

Najavits, L. M & Hien, D. (2013). Helping vulnerable populations: a comprehensive review of the treatment outcome literature on substance use disorder and PTSD. Journal of clinical psychology: in session, 69(5),  433–479.

Najavits, L. M. (2007). Seeking Safety: An evidence-based model for trauma/PTSD and substance use disorder. In K. Witkiewitz & G. A. Marlatt (Eds.), Therapist’s guide to evidence-based relapse prevention (pp. 141–167). San Diego, CA: Elsevier.

Najavits, L. M. (2009). Seeking Safety: An implementation guide. In A. Rubin & D. W. Springer (Eds.), The clinician’s guide to evidence-based practice (p. 409). Hoboken, NJ: Wiley.

Nunes, E. V. (2010,b). Do treatment improvements in PTSD severity affect substance use outcomes? A secondary analysis from a randomized clinical trial in NIDA’s Clinical Trials’s Network. American Journal of Psychiatry, 167(1), 95–101.

Nuu-Chah-Nulth Tribal Council. (1996). Indian Residential Schools: The Nuu-Chah-Nulth Experience. British Columbia: Nuu-Chah-Nulth Tribal Council.

Oliver, J.E. (1993). Intergenerational transmission of child abuse: Rates, research, and clinical implications. American Journal of Psychiatry, 150, 1315-1324.

Oliver, L.N., Peters, P.A., & Kohen, D. E. (2012). Mortality rates among children and teenagers living in Inuit Nunungat 1994-2008. Statistics Canada Health Report, 23, (3), 17-22.

Oulanova, O. & Moodley, R. (2010). Navigating Two Worlds: Experiences of Counsellors Who Integrate Aboriginal Traditional Healing Practices. Canadian Journal of Psychotherapy. 44(4), 346–362.

Palacios, J. F., & Portillo, C. J. (2009). Understanding Native women’s health: Historical legacies. Journal of Transcultural Nursing, 20(1), 15–27. doi:10.1177/1043659608325844.

Parker, L, Jamous, M, Marek, R, & Camacho, C. (1991). Traditions and innovations: a community-based approach to substance abuse prevention. Rhode Island Medical Journal, 74(6),  281-6.

Patitz, B. J., Anderson, M. L., & Najavits, M. L. (2015). An outcome study of Seeking Safety with rural community-based women. Journal of Rural Mental Health, 39(1), 54-58.

Poonwassie, A. & Charter, A. (2005). Aboriginal worldview of healing: Inclusion, blending, and bridging. In R. Moodley & W. West (Eds.), Integrating traditional healing practices into counseling and psychotherapy (pp. 15–25). Thousand Oaks, CA: Sage.

Porsanger, J. (2004). An essay about Indigenous methodology. Retrieved from getfile.php?PageId=977&FileId=188.

Proulx, J, and Perrault. P. (2000). No place for violence: Canadian Aboriginal alternatives. Canadian Cataloguing in Publication Data. Fernwood Publishing Company.

Public Health Agency of Canada. (2006). Mental health and well-being of Aboriginal peoples in Canada. In Government of Canada. The human face of mental health and mental illness in Canada (Chapter 12).

Ratnasingham, S., Cairney, J., Rehm, J., Manson, H., Kurdyak, P. A. (2012). Opening Eyes, Opening Minds: The Ontario Burden of Mental Illness and Addictions Report. An ICES/PHO Report. Toronto: Institute for Clinical Evaluative Sciences and Public Health Ontario.

Reimer, G., Bombay, A., Ellsworth, L., Fryer, S., & Logan, T. (2010). The Indian residential schools settlement agreement’s common experience [sic] payment and healing: A qualitative study exploring impacts on recipients. Ottawa, Ontario, Canada: Aboriginal Healing Foundation.

Restoule, J. P., (2004). Male Aboriginal identity formation in urban areas: A focus on process and context. (Doctoral dissertation). Retrieved from Dissertations & Theses: Full Text Database. (Publication No. AAT NQ94516).

Rice, B. (2005). Seeing the world with Aboriginal eyes: A four dimensional perspective on human and non-human values, cultures and relationships on Turtle Island. Winnipeg, Manitoba, Canada: Aboriginal Issues Press.

Robbins, J. A., & Dewar, J. (2011). Traditional Indigenous approaches to healing and the modern welfare of traditional knowledge, spirituality and lands: a critical reflection on practices and policies taken from the Canadian Indigenous example. International Indigenous Policy Journal, 4, 1-20.

Rojas, M. & Stubley, T. (2014). Integrating mainstream mental health approaches and Traditional Healing Practices. A literature review. Advances in Social Sciences Research Journal, 1(1), 22–43.

Rowan, M., Poole, N., Shea, B., Joseph, P., Gone, J. P., Mykota, D., Farag, M., Hopkins, C., Hall, L., Mushquash, C., & Colleen Dell, C. (2014). Cultural interventions to treat addictions in Indigenous populations: findings from a scoping study. Substance Abuse Treatment, Prevention, and Policy, 9(34), 1-26.

Smith, L. T. (1999). Decolonizing methodologies: Research and Indigenous peoples. London, England: Zed Books.  

Spittal, P. M., Craib, K.J.P., Teegee, M. et al. (2007). The Cedar project: prevalence and correlates of HIV infection among young Aboriginal people who use drugs in two Canadian cities. International Journal of Circumpolar Health. 66, 226-40. Available: /17655063 (accessed 2014 May 19).

Statistics Canada (2011). Aboriginal peoples survey (APS). Retrieved from

Statistics Canada. (2011). Aboriginal peoples in Canada: First Nations people, Métis and Inuit. National Household Survey, 2011. (analytic document - catalogue no. 99-011- X2011001). Ottawa, ON: Ministry of Industry, 2013.

Svenson, K. A. & LaFontaine, C. (1999). The search for wellness. In First Nations and Inuit regional health survey: National report. St. Regis, Quebec, Akwesasne Mohawk Territory: First Nations and Inuit Regional Health Survey National Steering Committee.

Thatcher, R. (2004). Fighting firewater fictions, moving beyond the disease model of alcoholism in First Nations. Toronto, Canada: University of Toronto Press.

Tousignant, M., & Sioui, N. (2009). Resilience and Aboriginal communities in crisis: Theory and interventions. Journal of Aboriginal Health, 5(1), 43-61.

Troniak, S. (2011). Addressing the Legacy of Residential School.  Retrieved from:

Truth and Reconciliation Commission Canada. (2015). The Survivors Speak: A Report of The Truth and Reconciliation Commission of Canada. Retrieved from

van der Kolk, B. (1987). Psychological trauma. Washington, DC: American Psychiatric Press.

van der Kolk, B. (2006). The body keeps the score: Brief autobiography of Bessel van der Kolk. In C. R. Figley (Ed.), Mapping the trauma and its wake: Autobiographic essays by pioneer trauma scholars (pp. 211-226). New York, NY: Routledge.

Vickers, J.R. (1992). Medicine Wheel. In Alberta Past, 8(3), 6-7.

Waldram, J. B. (1997). The way of the pipe: Aboriginal spirituality and symbolic healing in Canadian prisons. Peterborough, Canada: Broadview Press.

Waldram, J. B., Herring, D. A., & Young, T. K. (2006). Aboriginal health in Canada: Historical, cultural, and epidemiological perspectives (2nd ed.). Toronto: University of Toronto Press.

Wardi, D. (1992). Memorial candles: Children of the Holocaust. New York, NY: Routledge. (Original publication, 1990).

Warry, W. (1998). Unfinished dreams: Community healing and the reality of Aboriginal self- government. Toronto, Canada: University of Toronto.

Warry, W. (2008). Ending denial: Understanding Aboriginal issues. Toronto, Canada: University of Toronto.

Weller, L. A. (2005). Group therapy to treat substance abuse and traumatic symptoms in female veterans. Federal Practitioner, 27–38.

Wesley-Esquimaux, C. C., & Smolewski, M. (2004). Historic trauma and Aboriginal healing. Ottawa, Canada: Aboriginal Healing Foundation.

Whitbeck, L. B., Adams, G. W., Hoyt, D. R., & Chen, X. (2004). Conceptualizing and measuring historical trauma among American Indian people. American Journal of Community Psychology 33(3/4), 119–130.

Whitbeck, L. B., Chen, X., Hoyt, D., & Adams, G. (2004). Discrimination, historical loss and enculturation: Culturally specific risk and resiliency factors for alcohol abuse among American Indians. Journal of Studies on Alcohol and Drugs, 65, 409–418.

Whitbeck, L. B., Yu, M., Johnson, K. D., Hoyt, D. R., & Walls, M. L. (2008). Diagnostic prevalence rates from early to mid-adolescence among Indigenous adolescents: First results from a longitudinal study. Journal of the American Academy of Child and Adolescent Psychiatry, 47(8), 890–900.

Wilson, S. (2001). What is an Indigenous research methodology? Canadian Journal of Native Education, 25(2), 175–179.

Wilson, S. (2008). Research is ceremony: Indigenous research methods. Winnipeg, MB: Fernwood Publishing.

Witt, N. (2007). What if Indigenous knowledge contradicts accepted scientific findings? The hidden agenda: Respect, caring and passion towards Aboriginal research in the context of applying western academic rules. Educational Research in Review, 2(3), 225-235.

Wotherspoon, T. & Satzewich, V. (1993). First Nations: Race, class, and gender relations. Scarborough, ON: Nelson Canada.

Zlotnick, C., Najavits, L. M., & Rohsenow, D. J. (2003). A cognitive–behavioral treatment for incarcerated women with substance use disorder and posttraumatic stress disorder: Findings from a pilot study. Journal of Substance Abuse Treatment, 25, 99–105.

Zlotnick, C., Johnson, J., & Najavits, L. M. (2009). Randomized controlled pilot study of cognitive–behavioral therapy in a sample of incarcerated women with substance use disorder and PTSD. Behavior Therapy, 40(4), 325–336.


Internet Resources

Seeking Safety

This site offers information on Seeking Safety: A Treatment Manual for PTSD and Substance Abuse (Najavits 2002) as well as the research projects completed and in progress using this model.

Sidran Institute

Sidran Institute is a nonprofit organization that provides information to support people with traumatic stress conditions and to help educate mental health professionals and the public.

PILOTS Database

PILOTS is a bibliographical database covering Published International Literature on Traumatic Stress.

International Society of Traumatic Studies

The International Society for Traumatic Stress Studies offers fact sheets on traumatic loss and the emotional response both for professionals and for the public.

(Retrieved online from definition/definition.aspx).

See example chapter 12 (Is this Abuse?) from my book: Enlightenment Is Letting Go! Healing from Trauma, Addiction, and Multiple