Cognitive behavioural somatic therapy

1. Introduction

Version followed: Baranowsky & Gentry, Trauma Practice: A Cognitive Behavioral Somatic Therapy, 4th edition (Hogrefe, 2023). This is the structure and technique list of the 4th edition (Phase 0 plus three phases, about 70 techniques). Where the earlier editions (Trauma Practice: Tools for Stabilization and Recovery, Baranowsky, Gentry & Schultz, 2005/2011/2015) differ, this is noted.

What it is. Cognitive behavioural somatic therapy (CBST) is not a single protocol. It is a structured toolkit for trauma treatment by Anna B. Baranowsky (Traumatology Institute, Canada) and J. Eric Gentry (US; developer of Forward-Facing® Trauma Therapy). It sorts cognitive, behavioural, somatic and emotional/relational techniques into Judith Herman's (1992) tri-phasic model and adds a preparatory Phase 0 for the therapist. The book presents "nearly 70" techniques with step-by-step guidance, more than 40 video and audio demonstrations and 36 client handouts [source: Hogrefe 4th ed. product page; Tomlinsons table of contents]. It is a framework for selecting and sequencing techniques, not a fixed session-by-session manual. Several items are established methods by other developers, adopted into the toolkit: progressive relaxation, autogenics, systematic desensitization, stress inoculation training, Cognitive Processing Therapy, narrative exposure and biofeedback.

How change happens. The authors say almost all of CBST rests on reciprocal inhibition: exposure to traumatic material while the body stays relaxed, so the relaxed state gradually replaces the fear response [source: 4th ed. sample, p. 7; EASAP review 2011]. They name four "active ingredients" common to effective PTSD treatment [source: 4th ed. sample, pp. 2–3, 16–19; PESI Gentry seminar outline]:

1. therapeutic relationship and positive expectancy;
2. relaxation and self-regulation;
3. exposure or narrative (in vivo and imaginal);
4. cognitive restructuring and psychoeducation.

The therapist's own regulation is treated as part of the treatment. A "nonanxious presence" in a regulated, ventral-vagal state is described as supporting co-regulation and protecting the clinician. The ventral-vagal term comes from polyvagal theory as the authors use it, not established physiology [source: 4th ed. sample, pp. 5–6, 9–16].

Scope note: CBST is a talk-and-self-regulation method. The sources describe no therapist touch, and all body techniques below are done by the client on their own body [source: 4th ed. TOC and sample; synthesis].

2. Framework

[source: 4th ed. sample pp. 9–16, 50–52; Tomlinsons TOC; Lehmanns TOC of the earlier edition; EASAP review]

Treatment codes. Each technique carries one or more codes: R, RE, CR (sometimes CE in the TOC). The book's "Necessary Ingredients: Treatment Codes (R, RE, CR)" section defines them, but its text is not drawn on. From the active ingredients, the codes most likely stand for R = relaxation/self-regulation, RE = (relaxed) exposure, CR = cognitive restructuring [uncertain: inferred]. Use the codes to balance a session plan. Do not run an RE technique without an R skill the client can already use.

Each phase is split into four domains: Somatic, Cognition, Behavior, Emotion/Relation. Choose at least one tool per domain that fits the client's "relational and processing style" [source: Hogrefe product page; TOC].

Danger triage before trauma work (book Figure 6). Is the danger outside, a real and present threat such as ongoing abuse or an unsafe home? Then do not start memory work; first resolve the threat through behavioural intervention. Is the danger inside, fear driven by intrusive memories with no present threat? Then trauma work can begin, using arousal reduction, self-soothing and cognitive restructuring [source: 4th ed. sample, pp. 50–52].

Criteria for moving from Phase I to Phase II ("What Is Safety? Minimum Criterion"). The sample shows elements 3–5 of five. Elements 1 and 2 are not covered in the sources [uncertain]. A reasonable reading is that they concern present outside safety and symptom or behavioural stability [synthesis].

• (3) A battery of self-soothing skills. At minimum: sensory grounding (3-2-1 in the text, 5-4-3-2-1 in the TOC), safe-place visualization, progressive relaxation or another anxiety-reduction skill, a self-soothing routine (exercise, music, art, gardening), at least one containment strategy and at least one expression strategy.
• (4) Demonstrated self-rescue. The client starts narrating a traumatic memory. When affect rises, the therapist prompts them to use their skills to pull themselves out of a flashback, and they show they can. The authors compare this to teaching a novice sailor before rough seas.
• (5) A positive prognosis and a treatment contract. Agree shared goals, acknowledge the client's progress, give a hopeful prognosis, and ask what the client needs before Phase II starts.
• Not every criterion has to be fully met. The clinician judges whether a gap creates risk. Dissociation or regression are red flags that call for more stabilization.

Moving from Phase II to Phase III: no explicit criteria are given in the sources [uncertain]. Practical markers [synthesis]: the target memories can be recalled at low SUDS without flashback; the trigger list has been worked through; the residual difficulties are relational, meaning-related or behavioural rather than intrusive. The phases are not strictly linear. Return to Phase I whenever safety or regulation is lost [synthesis, consistent with Herman's model].

Session count and format. The sources give no fixed number of sessions. The model is individual and phase-based, adapted to the client. Techniques generally take 5–30 minutes, so most sessions combine one regulation skill with one phase task. The 4th edition adds a 30-day video stabilization programme and online-therapy options [source: TOC; product page; uncertain for durations other than the 5-minute Relaxed Breathing meditation]. Forward-Facing Trauma Therapy, included as a chapter, has three phases: Education → Intentionality → Practice (coaching and desensitization). It works mainly on present-day perceived threat rather than detailed memory processing [source: 4th ed. sample, p. 173ff; TOC].

Readiness tools across phases: SUDS ratings (0–10 or 0–100), the trigger list and the timeline [source: sample, pp. 55–58].

3. Guiding principles

[source: 4th ed. sample, Introduction and Phase 0; Hogrefe product page; EASAP review; PESI Gentry seminar pages. Practical meanings are synthesis.]

• Above all else, do no harm. Untrained therapists can retraumatize clients. → Do not open memory work you cannot help the client close and regulate from.
• Reciprocal inhibition is the engine. → Every exposure moment is paired with a relaxed body. If the client cannot relax, slow down or go back to Phase I skills.
• Self-of-the-therapist / nonanxious presence (Friedman's concept, adopted by the authors). → Track and settle your own arousal before and during sessions. Your regulation is an intervention.
• Therapist effects matter more than technique. → Invest in your own training, supervision, peer support and self-care (Phase 0) as much as in learning techniques.
• Relationship and positive expectancy (with feedback-informed treatment). → Build alliance on purpose, get regular client feedback on the work, and voice realistic hope.
• Safety before processing (phase-based care). → Check for outside danger first. Earn the move to Phase II by meeting the minimum criteria.
• Titration. → Approach traumatic material in small doses (one hot point, one layer) and alternate it with regulation ("braking").
• Client control and self-rescue. → The client must be able to stop and bring themselves back. Practise this before full exposure.
• Tailoring to relational and processing style. → Pick from the four domains (somatic, cognitive, behavioural, emotional/relational) to fit the client. The model is not run as a fixed sequence.
• Integration across domains. → If a client is stuck in one channel, for example cognitive, add a somatic or relational tool. The authors frame treatment resistance or failure as calling for integrative approaches.
• Self-regulation of the autonomic nervous system (polyvagal framing, the authors' model). → Teach clients to notice threat activation in the body and to downshift it themselves.
• Perceived versus real threat (Forward-Facing). → Help clients see that much of their reactivity is a response to perceived threat in the present, and practise staying regulated in the face of it.
• Intentionality / principle-based living (Forward-Facing). → Help the client define their own values and integrity and act from them rather than from reactivity. The PESI pages call these written statements "documents of intention": a covenant and a code of honor.
• Psychoeducation as treatment. → Explain traumagenesis and the stress physiology in plain language. Understanding reduces shame and helps the client stay in the work.
• Clinician self-care is part of the model. → Monitor yourself for compassion fatigue and secondary traumatic stress, and use the book's self-care model.

4. Intervention inventory

How to read this inventory. The technique list, phase, domain, treatment codes and page numbers come from the 4th-edition table of contents [source: Tomlinsons TOC; 4th ed. sample]. The book's own step-by-step text is drawn on only for the trigger list, the Phase I→II criteria and the Relaxed Breathing Guided Meditation. All other steps fall into two groups:

• (a) Steps following the standard published version of an adopted method: Jacobson, Schultz, Wolpe, Meichenbaum, Resick, Burns, Padesky, Schauer et al. These are marked [synthesis: standard method].
• (b) For CBST-specific names, a cautious reconstruction from the name, phase and code, marked [uncertain]. Check these against the book and its videos before relying on them.

All example language is illustrative. No technique below uses therapist touch. Touch is not described in the sources, and CBST is not a touch-based method [synthesis]. If you ever add touch, it needs specific training, supervision and a check of what your licence and jurisdiction allow.

Breath and body screening (applies to all breathing, relaxation, scanning and shaking tools). The book lists respiratory or nasal-airway problems as a counterindication for Relaxed Breathing [source: sample p. 92]. Also screen for the following [synthesis]: asthma or COPD; cardiovascular illness; pregnancy; epilepsy; recent injury or surgery, or chronic pain at the muscle sites (for tense-release work); psychosis; severe dissociation; panic set off by noticing the breath or body (relaxation-induced anxiety); and active suicidality without a safety plan. Offer eyes-open versions, and tell the client they can stop at any time.

Phase 0: Therapist preparation

Therapist self-regulation / nonanxious presence (Phase 0)

• Purpose: keep the clinician regulated (ventral-vagal in the authors' polyvagal framing) so they can co-regulate the client and are protected from secondary trauma [source: sample pp. 5–6, 9–16].
• Steps [synthesis]: (1) Before the session, take 2–3 minutes of slow breathing and a quick body scan. (2) In session, check your body at set points: jaw, shoulders, belly, pelvic floor, hands. (3) When you notice tension or a faster pulse, lengthen the out-breath and soften the muscle you found, without breaking eye contact or the flow of speech. (4) After the session, write a one-line note on what activated you. Take patterns to supervision or peer consultation.
• Example language: none (internal practice). With the client (illustrative): "Let's both slow down for a moment."
• Watch for: your own urgency, rescuing, numbing or speeding up. Each is a cue to regulate. It is working when you can hear the hardest material while keeping a soft body and steady voice.

Psychoeducation: traumagenesis and the stress physiology (Phase 0 content, used throughout)

• Purpose: normalise symptoms as threat-system responses and give the rationale for relaxation paired with exposure [source: TOC: Traumagenesis; The Mind-Body Connection].
• Steps [synthesis]: (1) Ask about one recent reaction. (2) Map it onto the alarm (amygdala), the time-stamping memory system (hippocampus), the sensory relay (thalamus), the sympathetic "accelerator" and cortisol. (3) Link problem behaviours to attempts to manage the threat. (4) Explain reciprocal inhibition: "relaxed and remembering cannot fully coexist with terror". (5) Give the handout and check what the client understood.
• Example language (illustrative): "Your alarm system learned to go off for things that resemble the danger. We'll teach your body to stay calm while it meets those reminders, and the alarm will gradually reset."
• Watch for: shame lifting and curiosity rising. Avoid overwhelming detail.

Phase I: Safety and Stabilization, Somatic

Creating a Nonanxious Presence (R–RE–CR, p. 52)

• Purpose: the client learns to keep a calm body while talking about distress. This is the in-session form of reciprocal inhibition and mirrors the therapist's Phase 0 work [source: TOC; the client-side steps are uncertain].
• Steps [uncertain]: (1) The therapist models a relaxed posture and slow speech. (2) The client notices where tension shows up as they mention a mild stressor. (3) The client releases that tension (breath, softening) and continues talking. (4) Repeat, gradually raising the topic intensity.
• Example language (illustrative): "As you say that, notice your shoulders. Let them drop a little, then keep going."
• Watch for: being able to talk and stay relaxed together.

Titration Part I: Trigger List (R–RE–CR, p. 55)

• Purpose: map traumatic material in manageable units, without processing it yet, for later titrated work [source: sample pp. 55–58].
• Steps: Multiple-event version. List triggering events by life stage (early childhood; middle childhood to adolescence; young adulthood; adulthood to present). Give each a short label (no detail) and a SUDS rating, then note themes or core beliefs. Single-event version. Lay the event out on a numbered timeline (1–10) from start to outcome and mark the "hot points" with an X. Capture the memory only; processing comes in Phase II [source: sample]. Keep labels to a few words and close with a grounding skill [synthesis].
• Example language (illustrative): "Just a title for each one, like a book spine. We're not opening any of them today."
• Watch for: rising SUDS while writing. Use braking. Breadth matters more than detail.

Using Braking and Acceleration (part of Titration I, p. 55)

• Purpose: teach the client to turn activation down ("brake") and to approach material deliberately ("accelerate"), so they control the pace [source: TOC. The terms parallel Rothschild's "braking" concept, but the book's text is uncertain].
• Steps [uncertain]: (1) Agree a brake: a practised grounding or breathing skill and a stop signal (word or hand). (2) Approach a low-SUDS item for a few seconds (accelerate). (3) Brake: shift attention to the room or breath until SUDS drops. (4) Repeat, lengthening the approach only as the client can brake reliably.
• Example language (illustrative): "Touch the edge of it… now brake. Feet, breath, the room. Where's your number now?"
• Watch for: the client braking on their own and SUDS falling within a minute or two.

Progressive Relaxation (R, p. 60)

• Purpose: reduce baseline arousal. This is the core R skill for reciprocal inhibition [source: TOC; EASAP review].
• Steps [synthesis: standard Jacobson-type method]: (1) Sit supported or lie down. (2) Work through muscle groups in order (hands, forearms, upper arms, face, neck, shoulders, chest, abdomen, legs, feet). Tense each for about 5 seconds at moderate effort, never to pain, then release for 15–20 seconds and notice the contrast. (3) Finish with slow breathing and a whole-body check. (4) Practise daily for 10–20 minutes; later shorten to release-only.
• Example language (illustrative): "Make a fist… hold… and let go. Notice the difference as the hand softens."
• Watch for: skip injured or painful areas. Watch for relaxation-induced anxiety or dissociation; offer eyes open and a shorter sequence. It is working when pre/post SUDS drop and the client can release tension on cue.

Autogenics (R–CR, p. 60)

• Purpose: deepen relaxation through self-suggestion. The CR code suggests calming self-statements are part of it [source: TOC; EASAP review].
• Steps [synthesis: standard Schultz-type autogenic formulas, simplified]: (1) Sit or lie comfortably. (2) Silently repeat formulas of heaviness, then warmth, in the limbs (e.g. arms heavy, arms warm), then calm heartbeat, easy breathing, warm abdomen and cool forehead. Repeat each several times. (3) End by deliberately alerting: deep breath, stretch, open the eyes. (4) Practise 2–3 times a day for a few minutes.
• Example language (illustrative): "Silently: 'My right arm is heavy'… let it be as heavy as it wants."
• Watch for: cardiac, blood-pressure or seizure conditions and psychosis (classic autogenic cautions) [synthesis]. Leave out the heart formula if the client fears palpitations. Watch for depersonalisation.

Diaphragmatic Breathing (R, p. 62)

• Purpose: a portable way to downshift arousal [source: TOC].
• Steps [synthesis: standard method]: (1) One hand on the chest and one on the belly, the client's own hands. (2) Breathe in through the nose so the lower hand rises and the upper stays fairly still. (3) Breathe out slowly through the nose or pursed lips. (4) 5–10 minutes, twice a day, then use it when triggered.
• Example language (illustrative): "Let the breath fill the belly like a balloon, and let it empty slowly."
• Watch for: over-breathing (tingling, light-headedness). If it appears, breathe more gently and slowly. Respiratory problems are a counterindication [source: sample p. 92].

3-6 Breathing (R, p. 62)

• Purpose: rapid calming by lengthening the exhale [source: TOC; the counts are inferred from the name, uncertain].
• Steps [uncertain]: breathe in for a count of 3 and out for a count of 6. Repeat for 1–3 minutes. Adjust the counts if this feels strained.
• Example language (illustrative): "In, two, three… out, two, three, four, five, six."
• Watch for: breathlessness; shorten the counts. It is working when the pulse and SUDS drop.

5-4-3-2-1 Sensory Grounding and Containment (R, p. 63)

• Purpose: interrupt flashbacks and dissociation by anchoring attention in present sensation. This is a minimum skill for moving to Phase II [source: sample p. 51; TOC].
• Steps [synthesis: standard method]: name aloud 5 things you see, 4 you hear, 3 you can feel or touch, 2 you smell and 1 you taste (or 1 good thing about yourself). Repeat with fewer items (3-2-1) when practised. Then "contain": put the remaining material away until later [uncertain: the exact containment step].
• Example language (illustrative): "Tell me five things you can see right now in this room."
• Watch for: a flat voice or delayed answers, which are signs of dissociation; then increase the sensory input. It is working when orientation returns and SUDS drop.

Postural Grounding (R, p. 64)

• Purpose: use posture to restore presence and a sense of strength [source: TOC; steps uncertain].
• Steps [uncertain]: (1) Sit upright with both feet flat and push gently into the floor. (2) Lengthen the spine, let the shoulders drop, lift the head and look around the room. (3) Optionally stand, with knees soft and weight shifting slightly side to side. (4) Name the change in felt safety or strength.
• Example language (illustrative): "Press your feet into the floor and notice the floor pressing back."
• Watch for: a collapsed posture returning. Practise briefly and often.

Anchoring Part I: Collapsing Anchors (R, p. 65)

• Purpose: link a cue to a resourced state and use it to weaken a distress state. Collapsing anchors comes from NLP; it is adopted here [source: TOC; book steps uncertain].
• Steps [uncertain, client self-touch only]: (1) The client recalls a calm or strong moment vividly. At its peak they press a chosen spot on their own body (for example, thumb to finger on one hand). Repeat to strengthen the link. (2) The client briefly recalls a mild distress state and anchors it at a different self-touch spot. (3) The client fires both anchors together and holds until the feeling settles. (4) Release the distress anchor first, then the positive one, and test with the mild stressor.
• Touch: do it with client self-touch. If a therapist-touch version is considered, explain it first, ask permission, offer the self-touch alternative, agree a stop signal, and check in during and after [synthesis].
• Example language (illustrative): "When the calm is strongest, press thumb and finger together."
• Watch for: use only mild distress states in Phase I. It is working when a lower SUDS follows the stressor.

Breathe 911 (R–CR, p. 66)

• Purpose: emergency calming that pairs breathing with a self-statement, for panic or flashbacks [source: TOC; the content is inferred from the name and codes, uncertain].
• Steps [uncertain]: (1) Recognise the alarm. (2) Breathe out long first, then breathe slowly. (3) Repeat a prepared coping statement. (4) Ground in the room.
• Example language (illustrative): "Long breath out. 'This is a memory, I'm safe now.'"
• Watch for: practise it when calm so it is available in crisis.

Body Scan (R, p. 67)

• Purpose: build interoceptive awareness and release tension [source: TOC].
• Steps [synthesis: standard method]: (1) Eyes open or closed. (2) Move attention slowly from the feet to the head, noticing sensation without changing it, and softening on the exhale. (3) 5–15 minutes. (4) Close by naming one neutral or pleasant sensation.
• Example language (illustrative): "Notice your feet… whatever is there is fine."
• Watch for: somatic flashbacks in areas linked to trauma. Let the client skip regions and keep the eyes open. Severe dissociation calls for a short, external-focused scan.

Relaxed Breathing Guided Meditation (R, p. 92)

• Purpose: physical coping in Phase I. About 5 minutes, no materials. Counterindicated with respiratory or nasal-airway problems [source: sample p. 92].
• Steps [source: sample p. 92, paraphrased]: (1) Sit or lie down somewhere quiet, setting aside thoughts of past and future. (2) Notice the breath without changing it and let it slow. (3) Notice the body's inner state without judging. (4) Breathe slowly into the belly and release fully. (5) Watch the breath come and go and let thoughts pass. (6) Release a little more tension with each exhale. (7) Recognise the practice as building calm and self-awareness. Audio: Video 21 of the book's materials.
• Example language (illustrative): "Just notice the breath, nothing to fix."
• Watch for: anxiety about focusing on the breath; switch to an external anchor.

30-Day Video Stabilization Program (Phase I adjunct)

• Purpose: daily guided stabilization practice between sessions or alongside online therapy [source: TOC; the content is uncertain].
• Steps [synthesis]: assign one short video a day, log practice and SUDS before and after, and review the log each session.
• Watch for: non-use (see section 5).

Phase I: Cognition

Anchoring Part II: Safety (R, p. 46 in the earlier edition)

• Purpose: anchor a felt sense of safety to a cue for later use [source: TOC; uncertain steps].
• Steps [uncertain]: build the safe state with sensory detail, link it to a word, image or self-touch cue at its peak, repeat 3–5 times, and test whether the cue recalls the state.
• Example language (illustrative): "Choose a word that holds this feeling."
• Watch for: "safety" may itself feel unsafe for some clients. Use "calm", "steady" or "strong" instead.

Safe-Place Visualization (R, p. 49 in the earlier edition)

• Purpose: an imagery resource for self-soothing. A minimum skill for moving to Phase II [source: sample p. 51; EASAP review].
• Steps [synthesis: standard method]: (1) The client chooses a real or imagined place of calm, with no trauma links. (2) Enrich it through every sense. (3) Notice where calm shows in the body. (4) Add a cue word. (5) Practise when calm, then on mild triggers.
• Example language (illustrative): "What do you hear there? What's under your feet?"
• Watch for: intrusions into the place. Move to another place or add protective features. Some clients do better with a "calm activity" instead.

Positive Self-Talk and Thought Replacement/Transformation (CR)

• Purpose: replace trauma-driven self-statements with realistic coping statements [source: TOC].
• Steps [synthesis: standard CBT]: (1) Catch the automatic thought during a trigger. (2) Rate how much you believe it. (3) Write a balanced alternative that is credible to the client. (4) Rehearse it aloud and on a card. (5) Use it during triggers and re-rate belief.
• Example language (illustrative): "What would you say to a friend who thought that?"
• Watch for: hollow affirmations. It is working when belief in the old thought falls.

Flashback Journal (R–RE)

• Purpose: track flashbacks, triggers and the skills that worked, building a sense of mastery [source: TOC; uncertain columns].
• Steps [synthesis]: after each episode, record the date, trigger, sensations, SUDS, the skill used, the SUDS after, and a short note that it was a memory and not now. Review it each session to spot patterns and update the trigger list.
• Watch for: writing too much detail, which pulls the client into the memory. Brief entries, then ground.

Buddha's Trick (R–CR, p. 58 in the earlier edition)

• Purpose: a brief relaxation-plus-reframe skill [source: TOC; content not found, uncertain]. Do not use it until you have checked the book's version.

Thought-Stopping (R–RE–CR, earlier edition only)

• Listed in the earlier edition and absent from the 4th-edition TOC [source: Lehmanns TOC vs Tomlinsons TOC]. Not recommended here, because suppressing thoughts can increase intrusions [synthesis].

Phase I: Behavior

Rituals (R–CR)

• Purpose: structured routines that signal safety and mark transitions, for example at bedtime or before and after sessions [source: TOC; uncertain detail].
• Steps [synthesis]: co-design a short, repeatable sequence (light a candle, breathe, say a statement, put an object away). Practise it in session and use it daily.
• Watch for: rituals that drift into compulsions.

Contract for Safety and Self-Care (R–CR)

• Purpose: an agreed set of self-care and safety commitments for stabilization [source: TOC].
• Steps [synthesis]: list the risk behaviours to reduce, the self-care behaviours to add (sleep, food, movement, contact) and who to contact when struggling. Both of you sign it and review it each week. A contract never replaces a suicide risk assessment and collaborative safety planning (see the safety net plan) [synthesis: current standard practice].
• Watch for: the client agreeing to it only to please you.

Safety Net Plan

• Purpose: a written plan for crises [source: TOC].
• Steps [synthesis: aligned with standard safety planning]: (1) personal warning signs; (2) internal coping skills; (3) people and places that distract; (4) people to ask for help; (5) professionals and crisis lines; (6) making the environment safer, which means lethal-means counselling: securing or removing means; (7) reasons for living. Keep a copy on the phone and review it after any crisis.
• Watch for: plans that are vague, untested or missing means safety.

Phase I: Emotion/Relation

Transitional Objects (R)

• Purpose: a tangible reminder of safety or connection to carry between sessions [source: TOC].
• Steps [synthesis]: the client chooses a small object such as a stone or card, links it to a calm state or to the therapy relationship, and carries and touches it when triggered.
• Watch for: distress if it is lost. Have a backup.

Support Systems (R–CR)

• Purpose: map and strengthen emotional supports [source: TOC; EASAP review].
• Steps [synthesis]: draw a support map (inner circle to outer), identify gaps and unsafe ties, plan one contact a week, and rehearse asking for support.
• Watch for: relationships that are still abusive (outside danger).

Drawing Icon and Envelope (Emotional Containment) (R–RE–CR)

• Purpose: contain overwhelming material between sessions [source: TOC; uncertain steps].
• Steps [uncertain]: the client draws a symbol ("icon") for the distressing material, seals it in an envelope, decides where it is kept (for example, in the therapist's office) and when it will be opened in therapy.
• Example language (illustrative): "It's safe in here until we choose to open it together."
• Watch for: containment used as permanent avoidance. Set a planned time to open it.

Internal Vault (Emotional Containment) (R–RE–CR)

• Purpose: an imagery version of containment [source: TOC; uncertain steps].
• Steps [uncertain]: imagine a strong container the client designs (lock, material, location). Place the material inside, lock it, and agree to retrieve it only in session.
• Watch for: material "leaking". Strengthen the image or add a guard.

Positive Hope Box (R–RE–CR)

• Purpose: a physical or digital collection of reminders of hope and reasons for living [source: TOC].
• Steps [synthesis: similar to the CBT "hope kit"]: gather photos, letters, music, coping cards and future plans, and open it when distressed. Review and add to it in sessions.
• Watch for: triggering items slipping in.

Make Peace with Your Sleep

• Purpose: stabilise sleep [source: TOC; uncertain content].
• Steps [synthesis: standard sleep hygiene and stimulus control]: keep fixed wake times, have a wind-down ritual, use the bed only for sleep, get up after about 20 minutes awake, limit caffeine and alcohol, and use a grounding script after nightmares. No medication advice.
• Watch for: nightmares (see Tame and Decode Bad Dreams) and sleep apnoea, which needs medical referral.

Phase II: Working Through Trauma (exposure safety first)

Before any RE technique [source: sample pp. 50–52 for the readiness criteria; the rest is synthesis]:

• Confirm there is no current outside danger. The client must have shown self-rescue and have a contract for Phase II.
• Get informed consent: explain the rationale (reciprocal inhibition), the expected temporary rise in distress, the right to stop, and the agreed stop signal.
• Defer or modify exposure for: active suicidality or recent self-harm; ongoing abuse; current psychosis or mania; severe dissociation without stabilisation; substance intoxication; unstable medical conditions made worse by high arousal (for example, cardiac). Pregnancy needs a gentler, titrated pace [synthesis].
• Rate SUDS at the start, at peaks and at the end. Close every session at a lower SUDS than the peak, using a Phase I skill. Schedule a post-session check-in plan.

Phase II: Somatic

Titration Part II: Braking and Acceleration (RE)

• Purpose: apply braking and acceleration to the hot points of a memory from the trigger list [source: TOC; steps uncertain].
• Steps [uncertain]: (1) Pick the lowest-SUDS hot point. (2) Approach it in short bursts of imagery or narrative (accelerate), keeping the body relaxed. (3) Brake to a grounding or breathing skill before SUDS goes above the agreed ceiling. (4) Return to the same point until its SUDS falls, then move to the next.
• Example language (illustrative): "Go to that moment just for a breath or two… now brake. Number?"
• Watch for: SUDS habituating within and across sessions. If the client cannot brake, go back to Phase I skills.

Layering (RE–CR)

• Purpose: approach a memory gradually, one layer of detail or sensory channel at a time, with cognitive work at each layer [source: TOC; uncertain steps].
• Steps [uncertain]: (1) Outline the event (facts only) and rate SUDS. (2) Add one layer at a time, for example images, then sounds, then body sensations, then thoughts and meanings. Keep the body relaxed and rate SUDS. (3) At each layer, note distorted meanings for CR. (4) Move to the next layer only when the current one is tolerable.
• Watch for: a jump in SUDS when a new layer is added. Brake and stay at that layer.

Comfort in One Part (RE)

• Purpose: keep a resourced body area as an anchor during exposure, for reciprocal inhibition through the body [source: TOC; uncertain steps].
• Steps [uncertain]: (1) Before exposure, the client finds a place in the body that feels comfortable or neutral (hands, feet, back against the chair). (2) Intensify that comfort with attention and breath. (3) During exposure, the client keeps part of their attention on that area. (4) When distress rises, shift attention fully to the comfortable area, then return.
• Example language (illustrative): "Where in your body is it okay right now, even a little? Keep a hand of attention there while we go on."
• Watch for: the comfortable area being "swallowed" by distress. Choose a more external anchor, such as the feet on the floor.

Timed Reflection

• Purpose: time-limited exposure, so approach is bounded and predictable [source: TOC; content not found, uncertain].
• Steps [uncertain]: agree a short fixed period of reflection on the memory (for example, a few minutes timed by the clock), stop exactly at the time, regulate, and review.
• Watch for: confirm the book's version before use.

Timeline Approach (RE–CR)

• Purpose: build a chronological life or trauma timeline to see patterns and place the trauma in the past [source: TOC; sample p. 57 notes it is similar to the multiple-event trigger list].
• Steps [synthesis]: (1) Draw a line from birth to the present. (2) Mark traumatic events above or below the line with SUDS, and also resources and positive events. (3) Process selected points with exposure and CR. (4) Note themes and core beliefs.
• Watch for: including resources keeps the timeline from becoming a catalogue of harm.

Biofeedback (R–RE–CR)

• Purpose: make arousal visible so the client learns to regulate it while recalling material [source: TOC].
• Steps [synthesis]: (1) Use a heart-rate, HRV, skin-conductance or temperature device. (2) Establish a baseline. (3) Practise lowering arousal (slow breathing) while watching the display. (4) Introduce trauma cues and keep the signal down.
• Watch for: anxiety about the numbers. It requires suitable training and equipment.

Hands Over Heart Space

• Purpose: soothing through the client's own touch during processing [source: TOC; uncertain steps].
• Steps [uncertain; self-touch only]: the client places one or both of their own hands over the centre of the chest, feels the warmth and pressure, and breathes slowly under the hands for a minute or more, optionally with a kind phrase.
• Watch for: some survivors find chest contact triggering. Offer the hands on the forearms or on the belly instead.

Paced Breathing

• Purpose: a steady slow-breathing rhythm during exposure [source: TOC].
• Steps [synthesis]: breathe at a slow, comfortable rate (often around 6 breaths a minute, about 4–5 seconds in and 5–6 out) with a pacer app or counting, for 5–10 minutes.
• Watch for: air hunger; slow down gradually.

Phase II: Cognition

Downward Arrow Technique (RE–CR)

• Purpose: uncover the core belief beneath a trauma-related thought [source: TOC; standard method from Burns].
• Steps [synthesis: standard method]: take the automatic thought and ask "If that were true, what would it mean about you, others or the world?" Repeat until you reach a core belief. Rate belief and emotion, then target the belief with CR.
• Example language (illustrative): "And if that were true, what would that say about you?"
• Watch for: shame spikes. Go slowly and validate.

Cognitive Continuum (CR)

• Purpose: soften all-or-nothing beliefs (for example "I'm completely to blame") [source: TOC; standard method from Padesky].
• Steps [synthesis: standard method]: (1) Draw a 0–100 line for the quality in question. (2) Define the end-points with concrete examples. (3) Place others on the line, then the client. (4) Discuss where they really sit.
• Watch for: a gradual shift in the rating.

Calculating True Danger (CR)

• Purpose: correct overestimates of threat [source: TOC; uncertain whether this is the probability-chain version].
• Steps [synthesis]: (1) Name the feared outcome and its estimated probability. (2) List each step that would have to happen for it to occur, and the likelihood of each. (3) Multiply them for a combined estimate. (4) Compare with the first estimate and with real-world evidence. (5) Plan coping if it did happen.
• Watch for: real present danger. Do not "calculate away" an outside threat.

Looped Tape Scripting (RE–CR)

• Purpose: repeated exposure to a written trauma script [source: TOC; uncertain steps].
• Steps [uncertain]: (1) The client writes a first-person, present-tense script of the memory or hot point. (2) Record it in their own voice. (3) Listen to it repeatedly in a relaxed body, in session and later as homework, rating SUDS until habituation. (4) Revise the script to add corrective meanings (CR).
• Watch for: homework only after in-session tolerance. Stop if SUDS stays high.

Cognitive Processing Therapy (RE–CR)

• Purpose: adopted from Resick et al.; addresses stuck points about the trauma [source: TOC].
• Steps [synthesis: summary of the CPT structure; follow the CPT manual and training]: psychoeducation, then an impact statement, then identifying stuck points, then ABC worksheets, then (optionally) a written account, then challenging-questions and patterns-of-problematic-thinking worksheets, then the five themes (safety, trust, power/control, esteem, intimacy), then a final impact statement. Usually about 12 sessions.
• Watch for: full CPT is a separate manualised protocol. Use it as a whole, not piecemeal [synthesis].

Story-Book Approach (RE–CR)

• Purpose: a narrative of the trauma as an illustrated or written "book" with a beginning, middle and end, useful with children or clients who are less verbal [source: TOC; uncertain].
• Steps [synthesis]: plan the pages (before, during, after, now and the future), draw or write each, read it together at regulated SUDS, and add a "now I am safe" ending.

Written Narrative Approach (RE–CR)

• Purpose: written exposure and meaning-making [source: TOC].
• Steps [synthesis]: write a detailed account including thoughts, feelings and sensations; read it aloud in session; rewrite it with new understandings; repeat until SUDS falls.

Corrective Messages from Old Storylines

• Purpose: identify old self-narratives formed by trauma and write corrective messages [source: TOC; uncertain].
• Steps [synthesis]: list the old storylines ("I'm always abandoned"), trace where they came from, write corrective messages based on evidence and compassion, and practise them.

Traumagram Exercise

• Purpose: a graphic overview of traumas across the lifespan and their intensity. The traumagram is generally credited to Figley [uncertain: attribution and book version].
• Steps [synthesis]: draw a timeline, mark each traumatic event with a bar whose height shows its impact, add themes and resources, and choose processing targets.

Phase II: Behavior

Behavior Change Rehearsal Exercise (RE–CR)

• Purpose: rehearse new responses to trigger situations [source: TOC].
• Steps [synthesis]: pick a situation, define the desired behaviour, rehearse it in imagery and then in role-play with feedback, carry it out in vivo, and review.

Skills Building Methods (CR)

• Purpose: build the skills trauma interrupted, such as problem-solving, communication and emotion regulation [source: TOC].
• Steps [synthesis]: identify the deficit, teach, model, rehearse, assign practice, review.

Imaginal and In Vivo Exposure (RE)

• Purpose: confront the memory (imaginal) and avoided safe situations (in vivo) [source: TOC; EASAP review].
• Steps [synthesis: standard prolonged-exposure-type procedure]: Imaginal. Recount the memory in the present tense with eyes closed if tolerable, at length, with SUDS every few minutes, repeated across sessions, then a processing discussion. In vivo. Build a hierarchy of safe but avoided situations with SUDS, do the items from the bottom up, and stay until distress declines. In CBST, pair both with relaxation.
• Watch for: only objectively safe in vivo targets. Watch for safety behaviours and dissociation.

Stress Inoculation Training (RE–CR)

• Purpose: adopted from Meichenbaum [source: TOC].
• Steps [synthesis: standard SIT phases]: (1) Conceptualisation: an education phase. (2) Skills acquisition and rehearsal: relaxation, breathing, self-statements for preparing, confronting, coping and reinforcing, problem-solving. (3) Application and follow-through: graded practice with stressors.

Systematic Desensitization (RE)

• Purpose: adopted from Wolpe; the classic reciprocal-inhibition method [source: TOC].
• Steps [synthesis: standard method]: (1) Train deep relaxation. (2) Build a 10–15 item hierarchy rated by SUDS. (3) In a relaxed state, imagine the lowest item for a short period. (4) If anxiety rises, stop and relax. (5) Repeat until the item stays calm, then move up.

IATP Narrative Exposure Therapy (RE)

• Purpose: the International Association of Trauma Professionals' version of narrative exposure [source: TOC; this version is uncertain. Standard NET is by Schauer, Neuner & Elbert].
• Steps [synthesis: based on the standard NET outline]: build a lifeline (for example, flowers for good events and stones for traumatic ones), then narrate life chronologically, processing each trauma in detail when it is reached. The therapist writes up the narrative and reads it back, and the final document is given to the client.

Phase II: Emotion/Relation

Learning to Be Sad (CR)

• Purpose: allow grief for losses caused by the trauma, in the "mourning" sense of Herman's phase 2 [source: TOC; EASAP review].
• Steps [synthesis]: name the losses, normalise sadness as distinct from depression, set aside bounded time for grief (a letter, a ritual, music), and stay regulated.
• Watch for: emerging major depression or suicidality, which needs reassessment.

Assertiveness Training (CR)

• Purpose: restore voice and boundaries [source: TOC].
• Steps [synthesis: standard method]: teach the difference between passive, aggressive and assertive; practise "I" statements, saying no and broken-record; role-play real situations; plan practice in real life.

Thematic Map and Release (TMandR)

• Purpose: a Phase II method by Baranowsky for identifying and releasing rigid trauma-related core beliefs, linked to DSM-5 Criterion D [source: UW Oshkosh video record].
• Steps [uncertain]: map recurring themes and beliefs (for example from the trigger list and timeline), rate their strength, and work on releasing them through exposure plus CR. Use the book or the authors' video for the actual procedure.

Grounding Lightstream

• Purpose: soothing imagery. The "lightstream" image is widely used in EMDR resourcing [uncertain: book version].
• Steps [synthesis]: the client focuses on a distressing body sensation and gives it shape, colour and temperature. They imagine a healing light of a chosen colour entering through the head and flowing to that spot, the sensation changing as it does, then the light filling the body. Close by grounding the feet.
• Watch for: clients who dislike imagery; use an external anchor instead.

Phase III: Reconnection, Somatic

Centering (CR)

• Purpose: a felt sense of a stable centre to return to in daily life [source: TOC; EASAP review names centering. Steps are uncertain].
• Steps [uncertain]: (1) Sit or stand, aligned. (2) Bring attention to the body's midline or lower abdomen. (3) Breathe there slowly. (4) Pair it with a values statement, which fits its CR code. (5) Use it before challenging situations.

Tame and Decode Bad Dreams

• Purpose: reduce nightmares and explore what they mean [source: TOC; steps uncertain].
• Steps [synthesis: drawing on imagery rehearsal-type approaches]: (1) Write the nightmare briefly. (2) Explore its themes ("decode"). (3) Change the script to a new, less distressing version chosen by the client. (4) Rehearse the new version in imagery for a few minutes each day. (5) Ground after waking from nightmares.
• Watch for: sleep-related breathing disorders and trauma that is still active, which point back to Phase II.

Going Slow to Heal After Trauma

• Purpose: deliberate slowing of pace and activity to support integration and prevent relapse into a high-arousal lifestyle [source: TOC; content is uncertain].
• Steps [synthesis]: identify daily rushing and over-activation, choose slow-down practices (unhurried walking, single-tasking, pauses between activities), and schedule recovery time.

Shake to Release

• Purpose: discharge residual tension through voluntary shaking [source: TOC; steps uncertain].
• Steps [uncertain; synthesis]: (1) Stand with feet hip-width apart and knees soft (or sit). (2) Gently shake the hands, then the arms, legs and whole body, at low intensity for 1–3 minutes, with the client controlling speed. (3) Stop, stand still, notice sensation and breathe. (4) Ground and talk it through.
• Contraindications and screening [synthesis]: recent injury or surgery, joint or back problems, pregnancy, cardiovascular illness, epilepsy, vertigo, severe dissociation, or a history of panic on strong body arousal. Keep it gentle and avoid cathartic escalation.
• Watch for: emotional flooding, which calls for stopping and grounding. It is working when the client reports lightness or relief and feels in control.

Phase III: Cognition

Exploring Your Cognitive Map (CR)

• Purpose: review how beliefs about self, others and the world have changed and what still needs work [source: TOC; uncertain].
• Steps [synthesis]: map key beliefs before and now by domain (safety, trust, power, esteem, intimacy), mark the shifts, and plan targets.

Victim Mythology (CR)

• Purpose: identify and challenge identity-limiting myths about being a victim, for example that a survivor is permanently damaged [source: TOC; EASAP review names it. Steps uncertain].
• Steps [synthesis]: list the myths the client holds, examine the evidence and where each came from, and rewrite them as survivor or thriver statements.

Self-Compassion Reflection

• Purpose: replace self-criticism with self-kindness [source: TOC].
• Steps [synthesis]: recall a moment of self-criticism, acknowledge the pain, recognise it as shared by others, and offer yourself kind words. Optionally do this with Hands Over Heart Space.

Letter to Self (CR)

• Purpose: consolidate learning and self-compassion [source: TOC; EASAP review].
• Steps [synthesis]: write to your past or future self covering what you endured, what you learned and what you want for yourself, then read it aloud in session.

Wellness Mind Map

• Purpose: a visual plan for wellbeing across life domains [source: TOC].
• Steps [synthesis]: put "well me" at the centre, branch out to body, mind, relationships, work and meaning, and add concrete actions on each branch.

Your Heart's Desire

• Purpose: clarify deeply held wishes and goals for the future [source: TOC].
• Steps [synthesis]: guided reflection on what you most want, translated into values and goals with first steps.

Phase III: Behavior

Self-Help and Self-Development (CR)

• Purpose: ongoing growth beyond therapy [source: TOC].
• Steps [synthesis]: choose resources (reading, groups, classes), set a plan, and arrange check-ins.

Picture Positive

• Purpose: build positive imagery of the future [source: TOC; uncertain].
• Steps [synthesis]: imagine a specific positive future scene in sensory detail, link it to the steps needed, and revisit it often.

Phase III: Emotion/Relation

Memorials (CR)

• Purpose: honour losses and mark the end of an era [source: TOC; EASAP review].
• Steps [synthesis]: the client designs a memorial act (planting, writing, a visit, an object) and carries it out, with or without others.

Connections with Others (RE–CR)

• Purpose: re-engage in relationships and community [source: TOC].
• Steps [synthesis]: identify desired connections, take graded steps toward contact (an RE element), process fears with CR, and review.

Codependency Revolution

• Purpose: change self-sacrificing relational patterns [source: TOC; content is uncertain].
• Steps [synthesis]: identify over-functioning and caretaking patterns, link them to their trauma origins, practise boundaries and asking for one's own needs.

Forward-Facing® Trauma Therapy (Gentry; chapter in the 4th edition)

• Purpose: rapid symptom relief by teaching autonomic self-regulation, then confronting perceived threats in daily life while regulated. The aim is to reduce reactivity without detailed memory processing [source: 4th ed. sample, p. 173ff; PESI seminar pages].
• Phase I: Education [source: TOC; PESI].
  • Steps [synthesis]: teach the threat-response model: the stress response fires "when there is little to no danger" (PESI description), and most present distress reflects perceived rather than real threat. Introduce self-regulation as the core skill. The PESI pages call this teaching "Tools for Hope" and an "Owner's Manual" for the autonomic nervous system.
  • Body cue: PESI names neuroception and interoception. Teaching sources widely link Gentry's core skill to releasing the muscles of the pelvic floor and the body when the client notices threat [uncertain: not confirmed].
• Phase II: Intentionality [source: TOC; PESI objectives].
  • Steps [synthesis]: the client writes "documents of intention": a covenant (a mission statement of how they intend to live) and a code of honor (principles they commit to). These define integrity and an internal locus of control. Identify where reactive behaviour has broken these principles.
• Phase III: Practice (Coaching and Desensitization) [source: TOC; PESI outline names in vivo exposure].
  • Steps [synthesis]: in daily life and in session, the client notices activation, releases muscle tension and stays relaxed while staying in contact with the perceived threat, which is in vivo desensitization through reciprocal inhibition. They then act in line with the covenant and code. The therapist coaches and reviews incidents.
• Example language (illustrative): "Notice the tightening… let your body soften while you stay right here with it."
• Watch for: perceived threat must be distinguished from real threat first. Relaxing in the face of real danger is not the goal.

Clinician self-care and compassion-fatigue models (Integrative and Clinician Self-Care Models section; Pinnacle Program and compassion fatigue in the earlier edition)

• Purpose: prevent and treat compassion fatigue, burnout, vicarious traumatisation and secondary traumatic stress [source: TOC; Lehmanns TOC; EASAP review].
• Steps [synthesis]: run the Phase 0 self-regulation practice daily; screen yourself periodically with a validated professional quality-of-life measure (do not reproduce its items); keep up supervision or peer consultation; set caseload limits; maintain life outside work; write your own intention statements. The Pinnacle Program's content is not drawn on [uncertain].

5. Handling problems

The sources address only a few of these. The book and the 2011 review note four: the risk of retraumatisation by untrained therapists; the difficulty of judging phase readiness; dissociation or regression as signs of premature progression; and comorbidity, especially personality problems [source: sample pp. 5–6, 50–52; EASAP review]. The book also has a section on "Treatment Resistance or Failure: Addressed with Integrative Approaches", whose text is not drawn on [uncertain]. Everything else below is [synthesis].

• Outside danger discovered mid-treatment (ongoing abuse, unsafe housing). [source: sample Figure 6] → Pause memory work. Return to Phase I and behavioural intervention: safety planning, advocacy, referrals, mandatory reporting where it applies.
• The client cannot reach the minimum criteria (no reliable self-rescue). [source: sample] → Extend Phase I. Change the domain: if breathing fails, try postural or sensory grounding; if imagery fails, use objects or behavioural rituals. Practise skills at very low SUDS first. Use the 30-day video programme for daily practice [synthesis].
• Dissociation or regression during titration. [source: sample] → Brake at once: eyes open, name the date and place, 5-4-3-2-1 aloud, feet pressing. Shorten the approach units, add Comfort in One Part, and consider more stabilisation. Screen for a dissociative disorder and get specialist consultation if it is suspected [synthesis].
• Overwhelm or flooding (SUDS above the agreed ceiling, panic, sobbing that will not settle). → Stop the exposure and use the brake skill. Do not end the session until SUDS is below the client's agreed level. Use containment (Internal Vault or Icon and Envelope) and plan a between-session check-in. Next time, use a lower ceiling and smaller units [synthesis].
• Relaxation-induced anxiety (calm feels dangerous; breath focus triggers panic). → Switch to external, active or eyes-open methods (postural grounding, sensory grounding, walking). Shorten practices to 1–2 minutes. Explain the reaction as the alarm misreading calm as unprotected [synthesis].
• Stuck: SUDS does not fall across exposures. → Check for subtle avoidance: skipping hot points, distraction, safety behaviours. Check that the body is actually relaxed during exposure, since without that there is no reciprocal inhibition. Check for an unaddressed stuck point or core belief (use Downward Arrow or Thematic Map and Release), for real present threat, and for substance use. Add a different domain [synthesis].
• Stuck: "I understand it but don't feel it." → Add somatic tools (Comfort in One Part, Hands Over Heart Space, body scan) or an experiential narrative in place of purely cognitive work [synthesis].
• Avoidance or resistance to Phase II. → Revisit the treatment contract and the client's goals. Use psychoeducation about avoidance maintaining symptoms. Offer choice of method (written, story-book, timeline, Forward-Facing present-focused work). Start with the lowest hot point. Respect the client's pace; resistance is information, not defiance [synthesis].
• Non-adherence to homework (practice, videos, journal). → Make tasks smaller (one breath practice a day), link them to existing routines, troubleshoot obstacles, and review the log at the start of every session. Ask whether practice itself triggers symptoms [synthesis].
• Ruptures (client feels pushed, unheard or unsafe with you). → Name it, take your share of responsibility, ask what would help, and adjust the pace. Feedback-informed treatment (session-by-session alliance and outcome feedback) helps detect ruptures early [source: PESI outline names feedback-informed treatment; the response steps are synthesis]. Check your own arousal (Phase 0): ruptures often follow therapist urgency [synthesis].
• Therapist activation or compassion fatigue (dreading sessions, numbing, rescuing). [source: sample; TOC] → Do Phase 0 self-regulation before and during sessions. Take it to supervision, adjust the caseload, and use the self-care model.
• Suicidality or self-harm emerging (often in Phase II or during grief work). → Do a standard risk assessment, update the safety net plan, include lethal-means counselling (secure storage and removal), increase contact and pause exposure until the client is stable. A "contract for safety" alone is not adequate [synthesis: current standard practice].
• Comorbid substance use or personality difficulties. [source: EASAP review names comorbidity] → Integrate substance-use treatment. Add emotion-regulation skills (Skills Building Methods). Extend Phase I. Watch for impulsive behaviour after exposure sessions [synthesis].
• Body-specific difficulties. → Shaking, breath work or body scans can trigger somatic flashbacks, pain or panic: offer eyes-open, seated, shorter versions and let the client skip body areas. Remind the client that these exercises are self-regulation tools, not treatments for physical disease, and refer physical symptoms for medical assessment [synthesis].
• Using a technique whose book steps you have not read (several are marked [uncertain] above). → Get the 4th edition and its video demonstrations, and follow them over the reconstructions here. Seek CBST or Forward-Facing training through the authors' institutes if you plan to use the model as your main approach [synthesis].

Sources

Sources:

• Trauma Practice: A Cognitive Behavioral Somatic Therapy, 4th ed. (Hogrefe product page)
• Trauma Practice 4th ed. sample content (Hogrefe "lese" PDF): front matter, Introduction, Phase 0 extract, Phase I pp. 50–58, p. 92, Forward-Facing summary
• Trauma Practice (4th ed.), bookseller listing with full table of contents (Tomlinsons)
• Trauma Practice: Tools for Stabilization and Recovery, earlier-edition table of contents (Lehmanns)
• Book review of Trauma Practice, East Asian Archives of Psychiatry 2011;21:170
• Thematic Map & Release: Resolving Core Beliefs After Trauma (Baranowsky, video record, UW Oshkosh)
• Forward-Facing Trauma Therapy: A Treatment Framework for Lasting Change (Gentry, PESI)
• Forward-Facing Trauma Therapy seminar (Gentry, Psychotherapy Networker catalog)
• Anna Baranowsky, official site
• Forward Facing Trauma Recovery podcast episode (Baranowsky with Gentry)
• Trauma Practice ebook listing (Litres)

Books cited (not fully opened):

• Baranowsky, A. B., & Gentry, J. E. (2023). Trauma Practice: A Cognitive Behavioral Somatic Therapy (4th ed.). Hogrefe.
• Baranowsky, A. B., Gentry, J. E., & Schultz, D. F. (2005; 2nd ed. 2011; 3rd ed. 2015). Trauma Practice: Tools for Stabilization and Recovery. Hogrefe.
• Gentry, J. E. (2016). Forward-Facing Trauma Therapy: Healing the Moral Wound. Compassion Unlimited.
• Herman, J. L. (1992). Trauma and Recovery. Basic Books.
• Standard methods referred to for [synthesis] steps: Jacobson (1938) Progressive Relaxation; Schultz & Luthe (1959) Autogenic Training; Wolpe (1958) Psychotherapy by Reciprocal Inhibition; Meichenbaum (1985) Stress Inoculation Training; Resick, Monson & Chard (2017) Cognitive Processing Therapy for PTSD; Schauer, Neuner & Elbert (2011) Narrative Exposure Therapy; Burns (1980) Feeling Good; Friedman, E. H. (1985) Generation to Generation (nonanxious presence).