In Reply Consistent with other research,¹ we² found that Seeking Safety (SS) did not outperform the comparison condition, in this case, prolonged exposure (PE). Najavits, SS’s developer who has acknowledged conflict of interest with SS, alleges 3 primary concerns with our study.

First, Najavits contends our study did not meet research standards for SS. We used standards and procedures we had used in previous studies. Najavits trained me in SS in 2006 when she was a consultant on my K award. I trained and supervised therapists in SS on that study and a pilot study we published together.³ I was coinvestigator on an R01 grant in which I trained and supervised SS therapists. In the present study, we used Najavits’s training videos, role plays, review of audio recordings, and weekly supervision methodology. Supervisors and fidelity raters were Veterans Administration (VA) psychologists who led clinics and training rotations treating comorbid alcohol use disorder and posttraumatic stress disorder (PTSD), including with SS. The primary SS supervisor and fidelity rater had been trained using the same procedures and had several years of experience delivering SS. Our fidelity rating form was downloaded from the Seeking Safety website (). Najavits states we combined sessions. We did not. We did extend length to 90 minutes to match that of the PE sessions.²