Trauma-sensitive yoga

Domain IV · Body-oriented psychotherapy · David Emerson, Bessel van der Kolk · 2002 · Brookline, Massachusetts

What it is

What it is: a hatha-yoga-based clinical intervention for complex trauma and chronic, treatment-resistant PTSD. David Emerson and colleagues developed it at the Trauma Center (JRI) in Brookline, Massachusetts. The publisher says Emerson co-created the Trauma Center Yoga Program with Bessel van der…

Format

• The sources do not describe TCTSY in formal therapy phases. It is organised as (a) referral and screening, (b) a fixed course of sessions, and (c) a repeating session arc inside each session. Forms progress slowly across weeks.
• Formats and dose (by version)

Who practises it, and how they are trained or regulated

• Group course, research protocol: 10 weekly classes of 60 minutes. Participants had to stay in ongoing supportive therapy (van der Kolk et al. 2014). The 2023 trial in women veterans with PTSD after military sexual trauma used the same 10 × 60-minute group format, with two TCTSY-certified facilitators per session. Completion was defined as attending at least 7 of 10 sessions (Zaccari et al. 2023).
• Fidelity and supervision. In the 2023 trial, facilitators wrote standardised session and fidelity notes straight after each session. A TCTSY co-founder gave weekly supervision with fidelity feedback and co-facilitator debriefs (Zaccari et al. 2023). Facilitators are certified through a 300-hour programme. They agree to the "Ways of Being" ethical code and keep good standing each year: a practice video, continuing…

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

• compliance driven by adult authority. Make refusing easy.
• a person who expects catharsis or memory work. Correct this before the course starts.
• speed and range competition between participants. Give the group the option to move more slowly or with a smaller range.
• drift from the method across cohorts. The 2023 trial kept consistency by having one lead facilitator and weekly supervision.
• the facilitator becoming a performance model. Show simple versions. It is working when participants look at their own bodies rather than at you.

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.