Ortho-Bionomy (Pauls)

1. Introduction

Version followed: Ortho-Bionomy® as the Society of Ortho-Bionomy International (SOBI) publishes it in its training-programme pages, Code of Ethics and Advanced Practitioner Training Program Handbook, supplemented by the SAGE encyclopedia entry (Rogers, 2015), the Kain & Berns manual listing and the Overmyer self-care book listing. Ortho-Bionomy is a hands-on bodywork method. This guide is written for the psychotherapist who refers to, collaborates with or prepares clients for an Ortho-Bionomy practitioner; it is not a manual for delivering the hands-on work.

• What it is. A gentle, non-forceful, positional bodywork method. The practitioner assesses areas of tension, pain, comfort and ease of movement, then uses gentle movements, comfortable positioning, brief compressions and subtle contacts, adjusted by the client's verbal feedback; no forceful movements or pressures are used [source: New Hope Ortho-Bionomy (McFadden) page]. Clients stay fully clothed and no creams or oils are used [source: Back to Basics Bodywork FAQ]. SOBI states that the work "helps people break the cycle of pain – without creating pain" [source: SOBI training page].
• Founder and origins. Developed by Arthur Lincoln Pauls, D.O., described as a British (or English) osteopath [source: SAGE entry; Penguin listing for Kain & Berns]. While in osteopathic college Pauls read Lawrence Jones's 1964 article on "Spontaneous Release by Positioning" (the forerunner of strain-counterstrain; see 049 Strain-counterstrain). Jones held a patient in a position exaggerating the lesion for an extended period; Pauls sought much shorter treatment times through subtle movement and gentle compression toward a joint, reportedly obtaining release in 30 seconds or less [source: SAGE entry]. Influences attributed to Pauls include martial arts, yoga, tai chi, fighting postures and sleep positions [source: SAGE entry]. He taught the system in the USA in 1976 and then in Europe, and insisted on the hyphen in the name as a reminder of the "vital gap" between practitioner and patient [source: SAGE entry]. [uncertain: not verified: Pauls's birth and death dates; a judo background is often mentioned but is not stated in the sources cited here.]
• Core idea of change (as attributed). Pauls called the approach the "correct application of the natural laws of life" [source: SAGE entry]. The stated mechanism is that moving the body toward comfort decompresses tissue and stimulates joint proprioceptors, signalling the nervous system to reset the area and let go of habitual tension patterns; the method is said to stimulate the body's "inherent, self-corrective reflexes" [source: SAGE entry; SOBI APTP Handbook]. Practitioners describe it as affirming the body's "inner wisdom" [source: McFadden page]. These are the developers' and practitioners' explanatory claims, not established physiology.
• Claims as published. Practitioner pages list pain relief, increased flexibility, improved circulation, whole-body relaxation and reduced anxiety, with relief said to last "for days or longer" [source: McFadden page; Back to Basics FAQ]. The SAGE entry reports SOBI's statement that the work is used in sports medicine, HIV/AIDS clinics and outpatient chemotherapy clinics [source: SAGE entry]; this is reported use as a comfort-oriented adjunct, not evidence that it treats any disease, and it must never be presented as a treatment for cancer, HIV or other physical illness.
• Evidence status. No randomised controlled trials or systematic reviews of Ortho-Bionomy specifically are cited by any of the sources used here; the SAGE entry gives no outcome data, and a 2025 consumer-science article describes direct evidence as "sparse" and based largely on anecdotal reports [source: SAGE entry; Biology Insights (Garrett, 2025)]. Treat the method as having no established evidence base of its own [uncertain: not verified: absence of any trials in the research databases]. Related positional-release research on strain-counterstrain is summarised in 049 Strain-counterstrain and should not be read across as evidence for Ortho-Bionomy.
• Who delivers it and regulation. SOBI, which holds the Ortho-Bionomy® and Sand Dollar trademarks, trains and registers practitioners and instructors [source: McFadden page; SOBI training page]. There is no government licence for Ortho-Bionomy as such: SOBI's handbook says it may fall under massage-therapy laws in some jurisdictions and be exempt in others, and tells practitioners to check with local and state governing bodies [source: SOBI APTP Handbook]. Many practitioners also hold a massage or other health licence; classes are open to massage therapists, bodyworkers, health professionals and interested lay people [source: SOBI training page]. The SAGE entry lists dentists, physicians, chiropractors, osteopaths, nurses, lymphatic-drainage therapists, physical and occupational therapists, bodyworkers, psychotherapists and social workers among those who use it [source: SAGE entry].

2. Framework

Ortho-Bionomy does not publish a staged treatment protocol with set session counts. Its "Phases" are named training classes (levels of the work), not treatment stages [source: SOBI APTP Handbook; Nagomi Healing Arts class page]. The framework below therefore has two parts: the published training and credential structure (useful for checking a practitioner) and a referral pathway for the psychotherapist [synthesis, built on the published session description].

2a. Credential structure (SOBI, as published)

[source: SOBI training page]. Each trainee has an Instructor advisor; review committees meet quarterly [source: SOBI training page]. Documented training sessions must last at least 30 minutes, "must consist entirely of Ortho-Bionomy", and the 150 session units must involve at least 20 different people; records include reason for visit, session notes and self-care given [source: SOBI APTP Handbook]. A Registered Practitioner may describe themselves as a "Registered Practitioner of Ortho-Bionomy" [source: SOBI APTP Handbook]. SOBI publishes a find-a-practitioner directory [uncertain: not verified: directory contents].

2b. Training classes named in SOBI materials

Phase Four (spine and pelvis; described as a foundation class covering history, philosophy and release techniques for each major joint), Phase Five, Phase Six, Phase Seven, Isometrics, Exploration of Movement Patterns, Postural Re-education and Post Techniques, Chapman's Reflexes, Cranial, Visceral, Self Care, Ethics and Emotional Issues, Elements of a Successful Practice, Demonstration Skills, Residential, Anatomy and Physiology, study groups and a Practitioner Training Seminar [source: SOBI APTP Handbook; SOBI training page; Nagomi Healing Arts class page]. One practitioner page notes that Pauls developed the later phases over time [source: McFadden page]. [uncertain: not verified: content of Phases One to Three.]

2c. Referral pathway for the psychotherapist [synthesis]

1. Indication and screening (psychotherapy session): the client wants a gentle, clothed, comfort-directed body approach for tension or pain alongside therapy; medical red flags have been excluded by the client's physician (Section 4, intervention A). Move on when the client has medical clearance where needed and a clear, non-curative expectation.
2. Practitioner selection: a SOBI Registered Practitioner or Registered Advanced Practitioner, plus any licence the jurisdiction requires (massage or other health licence) [source for credentials: SOBI training page; SOBI APTP Handbook]. Move on when credentials and scope are confirmed.
3. Preparation for touch (one or more psychotherapy sessions for trauma-affected clients): consent plan, stop signal, chaperone or support-person decision (intervention C). Move on when the client can state their stop signal and limits.
4. The Ortho-Bionomy session (delivered by the practitioner): about one hour, clothed, assessment of tension, pain, comfort and ease, then gentle positioning, movement, brief compressions and subtle contacts guided by the client's feedback; home self-care may be suggested [source: McFadden page; Back to Basics FAQ]. Number of sessions: not standardised in the sources [uncertain: not verified].
5. Integration (next psychotherapy session): what the client noticed, how consent felt, any emotional response (intervention D).
6. Review: continue, pause or stop based on the client's goals, comfort and any adverse effects (intervention E). Stop and refer back to medical care if pain worsens, new symptoms appear or the client feels unsafe.

3. Guiding principles

Principles of the method (as published; attribute them to Ortho-Bionomy when explaining to clients):

• Move toward comfort, never into pain. Movement is always directed toward comfort, which is said to encourage relaxation and trust [source: SAGE entry]; SOBI says the work breaks the pain cycle "without creating pain" [source: SOBI training page]. Practical meaning: if a client reports pain or forcing in a session, that is a departure from the method and should be raised with the practitioner.
• Non-force. No forceful movements or pressures [source: McFadden page]. Practical meaning: there are no high-velocity thrusts; a client describing manipulation or cracking is describing something other than Ortho-Bionomy.
• Self-correction. The practitioner positions; the body's "self-corrective reflexes" are said to do the changing [source: SOBI APTP Handbook; SAGE entry]. Practical meaning: frame sessions as offering the body an opportunity, not as the practitioner fixing the client.
• The client guides. The client's verbal feedback guides adjustments [source: McFadden page]; in Phase Five practitioners are "encouraged to do less and let the client be the guide" [source: SOBI APTP Handbook]. Practical meaning: the client's report of comfort or discomfort is the steering signal, which supports their agency and consent.
• The vital gap. The hyphen in Ortho-Bionomy signals a "vital gap" between practitioner and patient [source: SAGE entry]. Practical meaning: respect for the client's space and autonomy, consistent with trauma-informed practice [synthesis].
• Body, mind and spirit (attributed). Unresolved symptoms are said to affect thoughts, emotions and spirit, and resolving the somatic cause is said to bring wider integration; Phase Six links "energetic, emotional, and physical" levels [source: SAGE entry; SOBI APTP Handbook]. Practical meaning: these are the method's beliefs, not established facts; explore what the client makes of them without endorsing energy concepts as fact.
• Compatibility with other systems. Presented as compatible with any healing system and as preparation for mobilisation, movement and therapeutic exercise [source: SAGE entry; Penguin listing for Kain & Berns]. Practical meaning: it is an adjunct alongside medical and psychological care, not a replacement.
• Scope and referral. SOBI's Code of Ethics requires members to offer only skills in which they have been trained, follow local scope-of-practice rules, refer clients to "other qualified professionals" for matters beyond their scope, keep confidentiality, recognise "the vulnerability of the client", provide "a safe environment" and clearly distinguish Ortho-Bionomy from other modalities they use; transgression may lead to loss of membership [source: SOBI Code of Ethics page; SOBI APTP Handbook]. Practical meaning: an Ortho-Bionomy practitioner should not diagnose, give psychotherapy or present the work as treating disease.

Principles for the psychotherapist alongside the method:

• Consent before and during touch, with a right to stop. Touch needs informed consent, monitored over time, and the client may refuse or end touch at any time; genital or other sexual touch is "always inappropriate" [source: USABP Code of Ethics, Section VIII]. Practical meaning: rehearse the client's consent and stop signal before referral and check it afterwards.
• Never sexual touch; clinical language for intimate areas. All mainstream codes prohibit sexual contact with clients [source: BACP 2018 paras 34-35; UKCP 2019 item 4; APA 10.05; AAMFT 1.4]. Ortho-Bionomy is a clothed method; any work near the pelvis or chest should be discussed in plain, clinical terms, with pelvic-floor or other intimate-area concerns referred to regulated clinicians [synthesis].
• Stay within competence; keep roles separate. Mainstream talk-therapy codes contain no explicit touch provision but require practice within competence and referral when appropriate [source: BACP 2018 para 13; UKCP 2019 items 23-24; HCPC SOP 1.1]. Body-psychotherapy codes allow touch only with specific skills, prior information and consent [source: EABP Ethics Guidelines Principle 7; USABP Section VIII]. Practical meaning: a psychotherapist does not add Ortho-Bionomy to psychotherapy sessions unless their own code allows hands-on work and they hold SOBI training; SOBI itself requires that Ortho-Bionomy be distinguished from other modalities a member uses [source: SOBI APTP Handbook].
• Coordinate parallel care. When a client receives similar services elsewhere, consider the implications and discuss them with the client to minimise confusion [source: EABP Ethics Guidelines 6.b]. Practical meaning: agree with the client what information, if any, passes between you and the practitioner.
• Body experience is data, not proof. Sensations, images or emotions arising in bodywork are explored for their meaning now, not treated as evidence of past events [synthesis].

4. Intervention inventory

The inventory has two parts. Part 4a covers what the psychotherapist does around a referral (these are the psychotherapist's own steps and are [synthesis] unless a source is named). Part 4b describes each Ortho-Bionomy technique as SOBI and its practitioners publish it, so that the psychotherapist can explain it, prepare the client and recognise departures from it. Part 4b techniques are delivered only by trained Ortho-Bionomy practitioners and are not instructions for the psychotherapist. Where a psychotherapist is also SOBI-trained, see intervention F.

4a. The psychotherapist's role

A. Suitability and safety screening before referral

• Purpose: decide whether a gentle, clothed, comfort-directed bodywork referral fits the client, and make sure medical problems are not being routed into bodywork. Use when a client asks about bodywork, reports chronic tension or pain they link to stress, or wants a body-based adjunct to therapy.
• Steps:
  1. Ask about current medical care, diagnoses and medications. Practitioner guidance asks clients to disclose health problems and medications, and strongly advises a written recommendation from the client's doctor before any session if the client is under medical care [source: Back to Basics Bodywork FAQ].
  2. Ask the client to see their doctor first for any pain that is new, severe, worsening, unexplained, or accompanied by fever, weight loss, night pain, numbness, weakness, changes in bladder or bowel control, recent trauma or suspected fracture, calf swelling or redness, or chest pain or breathlessness [synthesis: general manual-therapy red flags; not an Ortho-Bionomy source].
  3. Ask the client to discuss with their doctor and the practitioner any recent surgery, osteoporosis, joint replacement, pregnancy, anticoagulant use, cancer or other serious illness [synthesis]. Practitioner pages describe the method as having "far fewer contraindications" because it is non-forceful [source: Back to Basics FAQ], but no SOBI contraindication list is available in the sources cited here [uncertain: not verified]. For physical-safety content on positional release generally, see 049 Strain-counterstrain.
  4. Screen for psychological readiness for touch: trauma history involving touch, dissociation, current crisis, active psychosis or mania, eating-disorder or body-image distress, and the client's own wish (or not) for touch [synthesis].
  5. Clarify expectations: the work is an adjunct for comfort and ease, not a treatment for disease and not psychotherapy [source for non-curative framing: SOBI Code of Ethics scope items; synthesis].
• Example language (illustrative): "Before I suggest anyone, can we check a few health things? If you're seeing a doctor for this pain, Ortho-Bionomy practitioners usually ask for a note from them first." / "This is gentle, clothed work aimed at comfort. It isn't a cure for a medical condition, and it doesn't replace what your doctor is doing."
• Watch for: pain the client has not had assessed; hoping bodywork will avoid a medical appointment; a wish for touch that seems driven by loneliness or by the therapy relationship. It is working when the client can say why they are going, what they hope for and what their doctor has said.

B. Choosing and briefing a practitioner

• Purpose: connect the client with an appropriately credentialed practitioner and set up collaboration.
• Steps:
  1. Ask for SOBI status (Registered Practitioner or Registered Advanced Practitioner) and how it was obtained (PTP 505 units; APTP 504 units, each including 150 documented session units and evaluation) [source: SOBI training page].
  2. Ask what licence the practitioner holds where they work; SOBI notes that Ortho-Bionomy may fall under massage laws in some areas and directs practitioners to local and state governing bodies [source: SOBI APTP Handbook]. In regulated massage jurisdictions, check the licensing body (for example, in Canada five provinces regulate massage therapy through a college) [source: Health Human Resources massage-therapist profile].
  3. Confirm the practitioner is bound by SOBI's Code of Ethics and knows how clients raise concerns (SOBI has a complaints and grievances process) [source: SOBI Code of Ethics page].
  4. With the client's written consent, agree what will be shared (for example, that the client is in therapy, any touch-related needs and stop signal) and what will not (content of therapy) [synthesis; see EABP 6.b on parallel services].
• Example language (illustrative): "I'd suggest someone who is a Registered Practitioner with the Society of Ortho-Bionomy International. It's reasonable to ask them about their training and whether they hold a massage licence where they work." / "Would you like me to let them know anything, such as that you'd like them to ask before each new contact? You decide what is shared."
• Watch for: practitioners who claim to diagnose, to cure disease, to retrieve memories or to do therapy; reluctance to discuss credentials. It is working when the client knows who they are seeing, what the person's credentials are and how to complain.

C. Preparing a trauma-affected client for touch-based work

• Purpose: reduce the risk that touch feels overwhelming or re-enacts past harm, and strengthen the client's agency. Use before the first bodywork session with any client who has a trauma history, especially one involving touch, and with anyone anxious about being touched.
• Steps:
  1. Explain what the published session involves: clothed, no oils, about an hour, gentle positioning and movement, brief compressions and light contacts, guided by the client's feedback [source: McFadden page; Back to Basics FAQ].
  2. Help the client draw up a consent plan: which areas are fine, which are off limits, whether they want each new contact announced, and how they prefer to lie or sit [synthesis; consent before and during touch: USABP Section VIII].
  3. Agree a clear stop signal (a word or a raised hand) and rehearse using it aloud; affirm that the client may refuse or end any touch at any time [source: USABP Section VIII.5].
  4. Decide about a chaperone or support person, door open or closed, and practitioner gender, and encourage the client to request these [synthesis].
  5. Practise brief grounding the client can use on the table, such as noticing the support under them or naming objects in the room [synthesis].
  6. Normalise that relaxation, tiredness, emotion or unexpected sensations can occur, and that none of these needs to be explained on the table [synthesis; practitioner pages report relaxation and an initial slowdown: Back to Basics FAQ].
• Example language (illustrative): "Let's practise your stop word now, out loud, so it's ready if you need it." / "You can ask them to tell you before they touch a new area. That's a normal request." / "If something comes up emotionally, you can pause, sit up, or end the session. We'll make sense of it together here."
• Watch for: fawning (agreeing to everything), freezing or going quiet when touch is discussed, or saying they "should" be able to tolerate it. It is working when the client states limits in their own words and can picture themselves using the stop signal.

D. Integrating body experience after a session

• Purpose: help the client make sense of sensations, emotions or memories that arose, and link changes in body awareness to therapy goals.
• Steps:
  1. Open with a neutral review: what the client noticed in their body during and after, how consent and pacing felt, whether their limits were respected [synthesis].
  2. Track present-moment sensation and feeling without pushing for content; slow down if the client becomes activated [synthesis].
  3. If images or memories came up, explore their meaning now and avoid treating them as proof of past events; do not suggest that the body "stores" specific memories that bodywork releases [synthesis: memory-research caution].
  4. Link any felt ease or tension to the client's goals (for example, noticing where stress shows up) [synthesis].
  5. Record what the client reports, including any adverse effects (intervention E).
• Example language (illustrative): "What did your body feel like when you walked out?" / "You mentioned some sadness came up while you were lying on your side. What is it like to notice that now?" / "We don't need to decide what that image means. Let's stay with what you notice here."
• Watch for: the client concluding they have uncovered abuse from a body sensation; flooding, dissociation or shame after a session; idealising the practitioner. It is working when the client can describe body experience with curiosity and choose what to do next.

E. Recognising and passing on adverse effects

• Purpose: catch physical or psychological harm early and route it to the right person.
• Steps:
  1. Ask after each session about pain, new symptoms, sleep, mood and any discomfort with how they were touched [synthesis].
  2. New or worse pain, numbness, weakness or other new physical symptoms: advise stopping bodywork and seeing a doctor; with consent, tell the practitioner [synthesis].
  3. Emotional overwhelm: pause bodywork, stabilise in therapy, then decide with the client whether to resume, slow down or stop [synthesis].
  4. Any sexual or boundary-crossing behaviour (sexual comments or touch, genital contact, pressure to undress, secrecy, dual relationships): treat as serious misconduct. Support the client in reporting to SOBI's complaints process and, where applicable, to the practitioner's licensing body, and to police if a crime may have occurred; follow your own code's safeguarding and confidentiality rules [source for SOBI complaints process and ethics: SOBI Code of Ethics page; sexual touch always inappropriate: USABP Section VIII; synthesis for the reporting route].
• Example language (illustrative): "Since the session, have you noticed anything new or worse, in your body or your mood?" / "That's not part of Ortho-Bionomy as it's taught, and it isn't OK. Would you like help thinking about who to tell?"
• Watch for: the client minimising or blaming themselves; delayed reactions a day or two later. It is working when concerns surface quickly and the client feels backed rather than judged.

F. When the psychotherapist is also an Ortho-Bionomy practitioner

• Purpose: handle dual training ethically.
• Steps:
  1. Check your own professional code. Mainstream talk-therapy codes have no explicit touch clause but require competence and boundary management [source: BACP 2018 paras 13, 33; UKCP 2019 items 8, 23-24; APA 2.01, 3.05]; body-psychotherapy codes permit touch with specific skills, prior information, informed (preferably written) consent and the right to stop [source: EABP Principle 7; USABP Section VIII].
  2. Follow SOBI's own rules: offer only skills in which you have been trained and distinguish Ortho-Bionomy clearly from other modalities you use [source: SOBI Code of Ethics page; SOBI APTP Handbook]. SOBI's handbook states that Practitioners may not teach Ortho-Bionomy or Ortho-Bionomy self-care to groups or workshops; teaching is reserved to Registered Instructors [source: SOBI APTP Handbook].
  3. The safer default is to keep the roles separate, referring psychotherapy clients to another practitioner for hands-on work rather than mixing it into psychotherapy sessions [synthesis].
  4. If your code and training do allow combined work, document assessment of suitability, written consent, periodic consent checks and consultation [source: USABP Section VIII.1-4].
• Example language (illustrative): "I'm trained in Ortho-Bionomy, but in our therapy I keep to talking. If you'd like that kind of work, I can suggest a colleague."
• Watch for: pressure from the client to be touched by the therapist; blurred roles; touch meeting the therapist's needs rather than the client's (USABP VIII.6). It is working when the client is clear which professional does what.

4b. Ortho-Bionomy techniques as published (for referral)

For each technique, "Steps" describes what the client can expect from a trained practitioner, as sources publish it; it is not a procedure for the psychotherapist. "Example language" is the psychotherapist's explanation to the client. Published descriptions are brief, so detailed hand positions are not given here [uncertain: not verified: detailed procedures in the Kain & Berns manual].

G. Comfort positioning (positional release)

• Purpose (as published): let the body release stress and pain patterns by holding it in a comfortable position, building on Jones's "spontaneous release by positioning" [source: McFadden page; SAGE entry]. The core technique of the foundation classes, taught region by region (for example spine, psoas, ilium and sacrum in Phase Four) [source: Nagomi Healing Arts class page; SOBI APTP Handbook].
• Steps (what happens): the practitioner finds areas of tension or tenderness and assesses comfort and ease of movement; gently moves the client into the position the client reports as most comfortable; holds it briefly while the body is said to self-correct; returns slowly; rechecks. Pauls aimed for release in 30 seconds or less, much shorter than Jones's holds [source: SAGE entry; McFadden page].
• Example language (illustrative): "They'll gently move you into whatever position feels easiest and hold you there for a short time. You're the one who says what feels comfortable."
• Watch for: reports of pain or being pushed into positions, which departs from the method; positions that feel exposing for trauma survivors (raise these in preparation, intervention C). Signs it suits the client: they describe the experience as relaxing and feel in control.

H. Gentle compression toward the joint

• Purpose (as published): Pauls's addition to Jones's work, said to speed release [source: SAGE entry].
• Steps (what happens): while the area is in a comfortable position, the practitioner applies brief, gentle compression toward the joint, sometimes with subtle movement [source: SAGE entry; McFadden page "brief compressions"].
• Example language (illustrative): "Sometimes they'll press very lightly toward a joint for a moment. It shouldn't hurt; if it does, say so."
• Watch for: any sense of force or pain; joint problems the doctor has not cleared (intervention A).

I. Movement toward ease and Exploration of Movement Patterns

• Purpose (as published): use subtle, comfort-directed movement to encourage the nervous system to let go of habitual tension; the Exploration of Movement Patterns class adds dynamic movement work, with functional anatomy, to positional release [source: SAGE entry; SOBI APTP Handbook].
• Steps (what happens): the practitioner moves a limb or area through small movements in the direction of ease, or guides the client's own active movements, adjusting by the client's feedback [source: McFadden page; SOBI APTP Handbook].
• Example language (illustrative): "They may ask you to move a little yourself, always in the direction that feels easier."
• Watch for: clients who override discomfort to please; encourage honest feedback.

J. Isometrics and isotonics

• Purpose (as published): address muscular tension patterns using isometric and isotonic techniques, with the practitioner providing restraint while the client engages the muscle; taught in the Advanced Practitioner programme [source: SOBI APTP Handbook; SOBI training page].
• Steps (what happens): the client gently engages a muscle against the practitioner's light resistance, then relaxes, as directed by the practitioner [source: SOBI APTP Handbook]. No repetitions or intensities are given here.
• Example language (illustrative): "At some points they may ask you to push gently against their hand. It's your effort, so you set how much."
• Watch for: strain, breath-holding or pain; restraint can feel like being held down for some trauma survivors, so prepare the client to ask for an explanation or to decline [synthesis].

K. Postural re-education and post techniques

• Purpose (as published): address postural habits, spinal curvatures and scoliosis, and integrate changes after a session; the SAGE entry also lists neuromuscular re-education, gait training and postural release [source: SOBI APTP Handbook; SAGE entry].
• Steps (what happens): at the end of a session or in later sessions the practitioner works with standing, sitting or walking patterns and may give post-session exercises [source: SOBI APTP Handbook].
• Example language (illustrative): "Near the end they may look at how you stand or walk and suggest small things to try at home."
• Watch for: body-image distress when posture is discussed; claims that the work will correct structural conditions such as scoliosis, which have no established evidence here and need medical management.

L. Phase Five (subtle awareness)

• Purpose (as published): build subtle awareness and proprioceptive sensitivity; practitioners are "encouraged to do less and let the client be the guide" for exploring change [source: SOBI APTP Handbook].
• Steps (what happens): lighter, slower contact and more attention to the client's own sense of where change wants to happen [source: SOBI APTP Handbook; detail [uncertain: not verified]].
• Example language (illustrative): "Some practitioners work very lightly and follow what you notice. Tell them what you feel, even if it seems small."
• Watch for: very light work can leave space for strong inner experience; check for dissociation or emotion afterwards (intervention D).

M. Phase Six (energetic perception)

• Purpose (as published): develop tracking of sensation and energetic perception; practitioners learn to "make contact without necessarily engaging physically", linking energetic, emotional and physical levels [source: SOBI APTP Handbook].
• Steps (what happens): the practitioner may work with little or no physical contact, holding hands near the body [source: SOBI APTP Handbook; detail [uncertain: not verified]].
• Example language (illustrative): "Part of the work may be done without touching you. Ortho-Bionomy describes this as working with energy; that's their framework, and you can ask what they're doing and why."
• Watch for: energy concepts are the method's beliefs, not established facts; clients who find non-contact work unsettling or who attribute special powers to the practitioner. Ask the practitioner to explain beforehand what they will do.

N. Phase Seven (patterns for self-correction)

• Purpose (as published): patterns for self-correction, described as a "non-forceful, elegant way to approach problems of many kinds" [source: SOBI APTP Handbook].
• Steps (what happens): no procedural detail is published in the sources cited here [uncertain: not verified].
• Example language (illustrative): "That's an advanced level of their training; ask them what it involves."
• Watch for: broad claims that it addresses "problems of many kinds" should not displace medical or psychological care.

O. Chapman's reflexes

• Purpose (as published): identify and stimulate reflex points said to support lymphatic drainage and organ balance, with a stated link to the endocrine system [source: SOBI APTP Handbook]. These are attributed claims, not established physiology.
• Steps (what happens): the practitioner palpates and gently stimulates specific reflex points [source: SOBI APTP Handbook].
• Example language (illustrative): "They may press some specific points that, in their system, relate to lymph and organs. It's fine to ask what each point is for."
• Watch for: any suggestion that this treats organ, hormonal or immune disease; refer such concerns to medical care.

P. Cranial work

• Purpose (as published): apply energy work to the cranial system so that the recipient can "find a better balance through the self-correcting reflexes" [source: SOBI APTP Handbook].
• Steps (what happens): light contact at the head and neck [source: SOBI APTP Handbook; detail [uncertain: not verified]].
• Example language (illustrative): "This is very light contact around the head. If having your head or neck held feels uncomfortable, you can say no to that part."
• Watch for: head and neck contact can be distressing for survivors of strangulation or assault; include it explicitly in the consent plan (intervention C). A Visceral class is also listed in SOBI materials [uncertain: not verified: content]; any abdominal or pelvic work should be discussed in clinical terms, and intimate-area concerns referred to regulated clinicians.

Q. Self-care (home release techniques)

• Purpose (as published): practitioners may suggest home release techniques to relieve pain, restore function and rebalance the body [source: McFadden page]; the SOBI Self Care class teaches exercises for clients and practitioners, including post-session exercises to help integrate changes [source: SOBI APTP Handbook]; self-care given is recorded in session notes [source: SOBI APTP Handbook]. Overmyer's book presents about 150 self-treatment techniques using positions, postures and movements, needing no equipment and done alone, organised by region (lower back, hip, knee, neck, shoulder, ribs, repetitive strain, arthritic hands, sciatica, menstrual cramps, posture, scoliosis and spinal flexibility), plus movements for strength and flexibility after pain subsides [source: Penguin Random House listing for Overmyer]. Its premise is that "the body inherently knows how to heal and self-correct, given the opportunity" [source: Penguin Random House listing].
• Steps (what happens): the practitioner shows the client a few comfort-directed positions or movements suited to their situation; the client uses them at home as instructed by the practitioner [source: McFadden page; SOBI APTP Handbook]. Specific movements, holding times and repetitions are not reproduced here; they come from the practitioner or the published book.
• Who may teach it: SOBI-trained practitioners for individual clients; SOBI's handbook states that Practitioners may not teach Ortho-Bionomy self-care to groups or workshops, which is reserved to Registered Instructors [source: SOBI APTP Handbook]. A psychotherapist without SOBI training should not teach these techniques; they can support the client's own practice [synthesis].
• Example language (illustrative): "How did the home positions go this week? What did you notice when you found the comfortable spot?" / "If any of them hurt, stop and check with the practitioner."
• Watch for: using self-care to avoid medical review; perfectionism or self-criticism about home practice; pain during self-care, which departs from the comfort principle. It is working when the client uses it as a calm, self-directed way to notice and ease tension.

5. Handling problems

Ortho-Bionomy sources say little about difficulties in the psychotherapy context; SOBI's Ethics and Emotional Issues class covers handling emotional responses professionally, but its content is not published in the sources cited here [source: SOBI APTP Handbook; [uncertain: not verified: class content]]. Unless a source is named, the guidance below is [synthesis].

• Emotional release during or after a session. Practitioner pages report relaxation, an initial slowdown and later more energy [source: Back to Basics FAQ]; SOBI classes link emotional and physical levels [source: SOBI APTP Handbook]. Response: normalise it, stabilise first (grounding, orientation, pacing), then explore meaning in therapy (intervention D). If emotion is intense or recurrent, pause bodywork until the client feels resourced, and agree with the client whether to tell the practitioner.
• Body sensations taken as recovered memories. A client may conclude from a sensation or image during bodywork that something happened to them. Response: take the distress seriously, explore the experience without confirming or denying events, explain that body sensations and images are not reliable evidence of specific past events, and avoid suggestive questioning. Practitioners should not interpret memories; if one does, raise it with the client.
• Overwhelm, freezing or dissociation on the table. Response: review the stop signal and consent plan; suggest asking the practitioner to work more slowly, to announce each contact, to avoid certain areas or positions (for example lying face down, or head and neck contact), or to work seated; consider a support person; shorten or stop the work if needed (intervention C).
• The client cannot say "stop" or keeps saying yes. Response: rehearse refusals in therapy; work on fawning or compliance as a therapy theme; suggest the client agree with the practitioner on a non-verbal signal.
• Expecting a cure or replacing medical care. Response: restate that the method is an adjunct for comfort and ease with no established evidence of its own [source: SAGE entry; Biology Insights]; insist on medical review for red-flag symptoms (intervention A); challenge claims that it treats cancer, HIV, organ, hormonal or structural disease.
• Pain or new symptoms after a session. Movement toward comfort and "without creating pain" are core to the method [source: SAGE entry; SOBI training page], so pain is a signal to stop and review. Response: advise medical assessment for new, severe or neurological symptoms; with consent, tell the practitioner; do not resume until cleared.
• Non-adherence to self-care. Response: explore meaning (avoidance, perfectionism, low mood, distrust of body practice) without pressing; remember self-care is optional and directed by the practitioner; never substitute your own exercise instructions.
• Attachment to or idealisation of the practitioner. Response: explore in therapy; watch for the bodyworker becoming a confidant in place of psychotherapy or medical care; SOBI's Code recognises the client's vulnerability and requires referral beyond the practitioner's scope [source: SOBI Code of Ethics page].
• Rupture in the therapy relationship about the referral. The client may feel you are passing them on or calling their problem "physical". Response: name and repair it, explain why you suggested it, and make clear it is optional and that therapy continues.
• Disagreement or confusion between providers. Response: with consent, clarify roles in a brief written exchange; keep therapy content confidential unless the client agrees otherwise [source: EABP Ethics Guidelines 6.b on parallel services].
• Energy concepts clash with the client's beliefs, or the client over-adopts them. Response: present Phase Six and cranial "energy" work as the method's own beliefs [source: SOBI APTP Handbook]; respect the client's view, ask what fits, and support their choice to decline those elements.
• Boundary violations or sexual misconduct. Any sexual touch, genital contact or sexualised comment is misconduct under every code cited here [source: USABP Section VIII; BACP 2018 paras 34-35; UKCP 2019 item 4; APA 10.05; AAMFT 1.4]. Response: believe and support the client, document, help them report to SOBI's complaints process and any licensing body, consider police involvement, follow your own safeguarding duties, and stop referring to that practitioner (intervention E).
• The client asks you to do the bodywork. Response: decline unless your code allows hands-on work and you hold SOBI training, and even then prefer separate roles (intervention F).

Sources

Web sources

• Ortho-Bionomy (Christopher J. Rogers), The SAGE Encyclopedia of Theory in Counseling and Psychotherapy (excerpt)
• SOBI: Training Programs
• SOBI: Code of Ethics
• SOBI: Registered Advanced Practitioner Training Program Handbook
• New Hope Ortho-Bionomy (Ann McFadden): What is Ortho-Bionomy
• Back to Basics Bodywork: Frequently Asked Questions
• Nagomi Healing Arts: Ortho-Bionomy classes (Phase 4)
• Penguin Random House: Ortho-Bionomy: A Path to Self-Care (Overmyer)
• North Atlantic Books: Ortho-Bionomy: A Path to Self-Care
• Penguin Books New Zealand: Ortho-Bionomy: A Practical Manual (Kain & Berns)
• Biology Insights (Melissa Garrett, 2025): Does Ortho-Bionomy Really Work? The Evidence
• USABP Code of Ethics
• EABP Ethics Guidelines (2020)
• BACP Ethical Framework for the Counselling Professions (2018)
• UKCP Code of Ethics and Professional Practice (2019)
• HCPC Standards of Proficiency: Practitioner Psychologists (2023)
• APA, Ethical Principles of Psychologists and Code of Conduct (2002, amended 2010 and 2016)
• AAMFT Code of Ethics (2015)
• Health Human Resources: Massage Therapists profile (Canada)

Books and articles cited

• Rogers, C. J. (2015). Ortho-Bionomy. In The SAGE Encyclopedia of Theory in Counseling and Psychotherapy (pp. 749-750). SAGE.
• Kain, K. L., & Berns, J. Ortho-Bionomy: A Practical Manual. North Atlantic Books (listing date 2011) [uncertain: not verified: original publication year].
• Overmyer, L. (2009). Ortho-Bionomy: A Path to Self-Care. North Atlantic Books.
• Jones, L. H. (1964). Spontaneous release by positioning (as cited in Rogers, 2015) [uncertain: not verified: journal details].
• Basham and Pauls article on the development of the Phases (as cited on the McFadden page) [uncertain: not verified: bibliographic details].

See also 049 Strain-counterstrain for the parent positional-release method and its safety content.