Therapeutic Spiral Model for trauma

Domain VIII · Creative & expressive arts therapies · Kate Hudgins, Francesca Toscani · 1990

What it is

The Therapeutic Spiral Model (TSM) is a clinically modified form of classical psychodrama for trauma survivors. Kate Hudgins (PhD, TEP) and colleagues, including Francesca Toscani, developed it from the early 1990s. They had found that classical psychodrama could retraumatise people. The first TSM…

Format

• Clinical map: the TSIRA in three stages. Hudgins (2019) presents the TSIRA as "a three-stage model to guide all action methods". The three groups of roles also set the order of treatment.
• Stage 1: Prescriptive (RX) roles. Hudgins (2019) names seven "consistent" RX roles, grouped by function. Observation: the observing ego. Restoration: three kinds of strength (personal or internal, interpersonal, and transpersonal). Containment: the body double, the containing double and the manager…

Who practises it, and how they are trained or regulated

• Assistant leader or other titled roles: TSI training material may define these; they are not documented in the sources used.
• TSM is taught by Therapeutic Spiral International through its International Certification Program in Trauma Therapy: Level I (Intro to Theory), Level II (Advanced Theory and Practice), a supervised practicum, and trainer certification. Online and hybrid options exist.
• TSM sits on a foundation of psychodrama training. In the US, psychodrama credentials are awarded by the American Board of Examiners in Psychodrama, Sociometry and Group Psychotherapy (ABE). The professional association is ASGPP. TSM trainers typically hold the TEP credential. In the UK, psychodrama psychotherapists train through British Psychodrama Association–accredited routes and register with UKCP. Elsewhere,…

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

• auxiliaries getting stuck in roles that touch their own unresolved trauma.
• it opening new material in someone who is not resourced. Use step-in data to decide whom to invite.
• members who did not share, or who look dissociated. Do a brief individual check-in before they leave.
• age regression beyond what the protagonist can observe. Keep the CD present and the adult self on stage.
• "strengths" that are really compliance or caretaking. Check with the observing ego whether the role is truly nourishing.

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.