Cognitive behavioural somatic therapy

Domain IV · Body-oriented psychotherapy · Anna B. Baranowsky, J. Eric Gentry · 2005 · Canada

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…

Who practises it, and how they are trained or regulated

• 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. Use the codes to balance a session plan. Do not run an RE…
• Moving from Phase II to Phase III: no explicit criteria are given in the sources. Practical markers: 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.
• 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. Forward-Facing Trauma Therapy, included as a chapter, has three phases: Education →…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• non-use (see section 5).
• triggering items slipping in.
• a gradual shift in the rating.
• air hunger; slow down gradually.
• rituals that drift into compulsions.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.