Project Summary

The U.S. Deaf community – a group of more than 500,000 Americans who communicate using American Sign Language (ASL) – experiences nearly triple the rate of lifetime problem drinking and twice the rate of trauma exposure compared to the general population. 

Although there are several treatments for alcohol use disorder (AUD) and posttraumatic stress disorder (PTSD) in hearing populations, none have been developed for or tested with Deaf clients. To address these barriers, our team developed Signs of Safety, a Deaf-accessible therapy toolkit for treating AUD and PTSD. 

We are conducting a nationwide, virtual clinical trial to compare (1) Signs of Safety with (2) treatment as usual and (3) a no treatment control, to collect data on clinical outcomes, and to explore potential mediators and moderators of outcome.


Project Status

Study start-up

Final Products

“Signs of Safety” is an adaptation based on the book Seeking Safety: A Treatment Manual for PTSD and Substance Abuse (Najavits, 2002, copyright Guilford Press, New York). It was adapted with permission by Guilford Press and Treatment Innovations. For further information on adaptation of the book, please contact and/or visit

ASL Teaching Stories​

Client Handouts​

Therapist Manual