Trauma-Informed Physical Activity

Application of yoga in residential treatment of traumatized youth
Spinazzola, J., Rhodes, A. M., Emerson, D., Earle, E., & Monroe, K. (2011). Application of Yoga in Residential Treatment of Traumatized Youth. Journal of the American Psychiatric Nurses Association, 17(6), 431-444.
Abstract from Article: “Background: The Trauma Center at Justice Resource Institute has adapted a form of Hatha yoga into a trauma-sensitive adjunctive component of intervention for use with complexly traumatized individuals exhibiting chronic affective and somatic dysregulation and associated behavioral, functioning, and health complaints. Objectives: This article explores the use of yoga with traumatized youth (aged 12-21 years) in residential treatment. Design: A review of the literature on the somatic impact of trauma exposure provides a rationale for the use of yoga with this population and highlights an emerging evidence base in support of this practice. Case vignettes illustrate the integration of structured, gentle yoga practices into residential programming for youth with severe emotional and behavioral problems. Results: Anecdotal data and clinical observation underscore the promise of yoga as a viable approach to build self-regulatory capacity of traumatized youth. Conclusions: Future directions in the development and evaluation of trauma-informed yoga practices for youth are discussed.”

Equine Facilitated Therapy for Complex Trauma (EFT-CT)
Naste, T., Price, M., Karol, J., Martin, L., Murphy, K., et al. (2017). Equine Facilitated Therapy for Complex Trauma. Journal of Child Adol Trauma, 1-15.
Abstract from Article: “Emerging research suggests that Equine Facilitated Psychotherapy (EFP) may be beneficial for traumatized youth. In addition, complex trauma (i.e., multiple and/or prolonged developmentally adverse traumatic events which are typically interpersonal in nature) treatment research is still growing and there is a need for the development and examination of novel treatments for youth with complex trauma histories. The current article describes a promising EFP model for this population called Equine Facilitated Therapy for Complex Trauma (EFT-CT). EFT-CT embeds EFP practices within Attachment, Regulation and Competency (ARC), an extant evidence-based complex trauma treatment framework for children and adolescents. The authors provide three case studies using both observational data provided by clinicians, as well as longitudinal measures of psychosocial functioning, to illustrate the potential promise of EFT-CT. The article concludes with a discussion about implications for EFP treatment and research.”

Play to the Whistle: A Pilot Investigation of a Sports-Based Intervention for Traumatized Girls in Residential Treatment
D’Andrea, W., Bergholz, L., Fortunato, A., & Spinazzola, J. (2013). Play to the Whistle: A Pilot Investigation of a Sports-Based Intervention for Traumatized Girls in Residential Treatment. Journal of Family Violence, 28(7), 739-749.
Abstract from Article: “Adolescents in residential treatment settings have symptoms that prevent them from participation in normal youth activities, which in turn prevent development of social skills and competencies. A sports-based intervention called “Do the Good” (DtG) was designed for this population using trauma-informed treatment principles. This paper describes the intervention model and presents outcome data. A total of 88 female residential students aged 12 to 21 participated, including 62 students voluntarily enrolled in the sports league and 26 treatment-as-usual (TAU) comparisons. Positive behaviors (e.g., helping peers, perseverance) during games were observed and coded for sports league participants and their coaches. Mental health charts of DtG and TAU participants were reviewed for behavior and symptoms prior to program participation, and again post-program. Girls in the sports league exhibited reductions in restraints and time-outs, as well as internalizing and externalizing symptoms. These data provide evidence that sports-based interventions present a promising adjunctive approach for traumatized youth.”

Playing to Heal: Designing a Trauma-Sensitive Sport Program
Playing to Heal: Designing a Trauma-Sensitive Sport Program. (2013). Boston, Massachusetts: Edge Work Consulting. Retrieved from http://www.edgeworkconsulting.com/assets/PlayingToHealEdgeworkJUNE2013.pdf
Highlights from Paper: “This paper is intended to offer frontline youth sport programs a practical framework for creating a trauma-sensitive intervention and to increase their capacity to support young people in their own healing process.”

The Doc Wayne athletic League: An Adjunctive therapeutic intervention for residential school girls
D’Andrea, W. 2013. The Doc Wayne athletic League: An Adjunctive therapeutic intervention for residential school girls, 1-15. Retrieved from http://www.edgeworkconsulting.com/assets/Evaluation-of-the-Doc-Wayne-Athletic-League2009.pdf
Highlights from Report: “From the perspective of trauma-informed care, this program involves gold-standard adjunctive treatment delivered in a highly efficient fashion. The DTG curriculum has the potential to significantly impact a large number of traumatized children in a relatively easy-to-deliver manner, as all coaches are laypersons and not therapists. The program has met its goals of effective adjunctive treatment for dysregulation of emotion and behavior and stands alone as one of the few programs nationwide, which can demonstrate such significant impacts with this population.”

Women on the Move: Trauma-informed interventions based on Sport and Play
Ammann, P., Matuska, N. 2014. Women on the Move – Trauma-informed interventions based on Sport and Play, Principles. Swiss Academy for Development (SAD). Retrieved from https://www.sportanddev.org/en/document/manuals-and-tools/women-move-trauma-informed-interventions-based-sport-and-play
Purpose of the toolkit: “Different approaches have been identified in order to address the treatment and support the needs of trauma survivors. Trauma-specific practices take a direct approach, specifically addressing trauma and its effects and the need to find means for recovery, for example through counselling and clinical interventions. However, this toolkit focuses on the trauma-informed approach. This is an approach which does not intend to deal with trauma directly, but creates an awareness of the issues related to trauma and the vulnerabilities of trauma survivors. Emphasis is placed on raising trauma awareness, creating a safe, non-violent environment in which the survivor can be empowered to make choices, collaborate and learn.”

Yoga as an Adjunctive Treatment for Posttraumatic Stress Disorder: A Randomized Controlled Trial
Kolk, B. A., Stone, L., West, J., Rhodes, A., Emerson, D., Suvak, M., & Spinazzola, J. (2014). Yoga as an Adjunctive Treatment for Posttraumatic Stress Disorder. The Journal of Clinical Psychiatry, 75(06).
Abstract from Article: “More than a third of the approximately 10 million women with histories of interpersonal violence in the United States develop posttraumatic stress disorder (PTSD). Currently available treatments for this population have a high rate of incomplete response, in part because problems in affect and impulse regulation are major obstacles to resolving PTSD. This study explored the efficacy of yoga to increase affect tolerance and to decrease PTSD symptomatology. Method: Sixty-four women with chronic, treatment-resistant PTSD were randomly assigned to either trauma-informed yoga or supportive women’s health education, each as a weekly 1-hour class for 10 weeks. Assessments were conducted at pretreatment, midtreatment, and posttreatment and included measures of DSMIV PTSD, affect regulation, and depression. The study ran from 2008 through 2011. Results: The primary outcome measure was the ClinicianAdministered PTSD Scale (CAPS). At the end of the study, 16 of 31 participants (52%) in the yoga group no longer met criteria for PTSD compared to 6 of 29 (21%) in the control group (n=60, χ2 1=6.17, P=.013). Both groups exhibited significant decreases on the CAPS, with the decrease falling in the large effect size range for the yoga group (d=1.07) and the medium to large effect size decrease for the control group (d=0.66). Both the yoga (b=−9.21, t=−2.34, P=.02, d=−0.37) and control (b=−22.12, t=−3.39, P=.001, d=−0.54) groups exhibited significant decreases from pretreatment to the midtreatment assessment. However, a significant group×quadratic trend interaction (d=−0.34) showed that the pattern of change in Davidson Trauma Scale significantly differed across groups. The yoga group exhibited a significant medium effect size linear (d=−0.52) trend. In contrast, the control group exhibited only a significant medium effect size quadratic trend (d=0.46) but did not exhibit a significant linear trend (d=−0.29). Thus, both groups exhibited significant decreases in PTSD symptoms during the first half of treatment, but these improvements were maintained in the yoga group, while the control group relapsed after its initial improvement.”

Yoga Therapy in Practice: Trauma-Sensitive Yoga: Principles, Practice, and Research
Emerson, D., Sharma, R., Chaudhry, S., Turner, J. 2009. Yoga Therapy in Practice: Trauma-Sensitive Yoga: Principles, Practice, and Research. INTERNATIONAL JOURNAL OF YOGA THERAPY (19).
Abstract from Article: “Since 2003, the Trauma Center Yoga Program at the Justice Resource Institute in Brookline Massachusetts has been providing Yoga to a variety of trauma survivors, including war veterans, rape survivors, at-risk youth, and survivors of chronic childhood abuse and neglect. Pilot study results have demonstrated the benefits of Yoga for individuals suffering from post-traumatic stress disorder. The Trauma Center Yoga Program also trains Yoga instructors and clinicians in how to offer Yoga to trauma survivors. This paper describes best principles and practices of teaching Yoga to survivors of trauma.”