This study was assesses the impact of Somatic Experiencing on symptoms of depression and anxiety in homeless adults. It is a non-blinded match control group study.

1. ASSESSING THE
EFFICACY OF SOMATIC
EXPERIENCING
FOR REDUCING
SYMPTOMS OF ANXIETY
AND DEPRESSSION

2. Somatic Experiencing Restoring
Innate Resilience
“Nature has instilled in all animals,
including humans, a nervous system capable of
restoring equilibrium. When self-regulating
function is blocked or disturbed… symptoms
develop.”
(Foundation for Human Enrichment, 2007. p. B1.4).

3. This slide show will address
four questions…
• Why this study?
• Why this study now?
• How this study was conducted?
• What this study found?

4. Why this study?
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Increasing resilience could help homeless
adults to find: work, obtain housing and
develop a support system.

5. Resilience
 Resilience is the ability to bounce back after
life stressors (Luthar, 2003).
 Resiliency models include: risk factors,
protective factors and growth due to positive
coping (Luthar, 2003).
 Somatic Experiencing is a resiliency based
treatment model.

6. Why This Study?
 Homelessness is a highly stressful life event that can shake
people’s confidence in themselves and life.
 Homeless adults are exposed to significant amounts of
trauma and increased life stress due to being homeless.
 Mental health difficulties could decrease the ability of
homeless adults to effectively engage with services.
 A short-term psychological first aid model aimed at
stabalization could decrease the mental health sequilae of
homelessness in a cost effective resource efficient
manner.

7. QuickTimeª and a
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8. Why Now? Somatic Experiencing Studies
 55 survivers of the South Asian Tsunami were given
between one and two individual sessions and affect
regulation skills training (Leitch, 2007).
 At two to three days following the first session
individuals showed 90% improvements.
 At two to three days following the second session
84% of individuals reported complete or partial
remission of symptoms.

9. Somatic Experiencing Studies
 Leitch (2009) TRM (trauma resiliency model) was
used with care providers in the aftermath of
hurricanes Katrina and Rita.
 Case workers and social workers (n = 142) were
given between one and three sessions and skills
training in affect regulation.
 All participants showed increased symptoms. The SE
group show significantly less increase in symptoms
then the wait list control group.

10. Why this study now?
 Somatic Experiencing Psychological first-aid
models have shown some efficacy in the
aftermath of extreme events.
 No studies to date directly measure Somatic
Experiencing’s effects on symptoms depression.
 No studies currently assesses the Somatic
Experiencing model for reducing mental health
symptoms for people who are homeless.

11. Why measure depression and
anxiety?
 Increased life stress can lead to increased depression
and anxiety.
 The Somatic Experiencing model conceptualizes
depression and anxiety as symptoms of a dysregulated
autonomic nervous system.
 Bosnian refugees at 7 mo people with symptoms of
depression were 9.5 times more likely to also display
symptoms of trauma.
 Cortisol dysregulation is found in many mental health
disorders.

12. Methods Overview
 A matched between groups pre-test post-test
matched control group design.
 Sample: A convenience sample of adults
who are currently living at COTS shelter.
(N = 18 in each group)
 Matching Criteria: Years homeless, age,
gender.

13. Results: What this study found.
 Symptoms of depression were not
significantly different at measurement three.
 Symptoms of trait anxiety were not
significantly different at measurement three.
 Symptoms of state anxiety were significantly
different between groups at measurement
three.

14. State Anxiety

15. State Anxiety Significance
 Multivariate statistical analysis
 Parallelism: F(2, 48) = 4.938, p = .011
 Flatness p = .007;
 Levels were not found to be significant.
 Between groups contrasts was significant p = .009 for the
liner function and approached significance with p = .054 for
the quadratic function
 Multivariate discriminant analysis
 Wilks Lambda: p = .031
 72.5% assignment of cases to the proper group
 50% would be expected with random assignment.

16. Results: Independent Sample t-tests
 A sub-sample (control n = 7, experimental n = 12)
were measured on five occasions.
 No significant difference between any level of
measurement was found at the initial measurement or
at the fourth measurement.
 At measurement five: cognitive and somatic
symptoms of depression were found to be significant
(p = .046, p = .023).
 Total score on the BDI-II approached sig. (p = .058)

17. Results: Covariate Analysis
 When the number of individual sessions is entered as
a covariate somatic and cognitive symptoms of
depression both became significant.
 Cognitive - Parallelism: p = .007, Flatness: p = .
006, Levels: not sig., Liner contrasts p = .035.
 Somatic - Parallelism p = .003, Flatness: p = .002
Levels: not sig., Liner contrasts: p = .001.
 Total score on the BDI-II approached significance.

18. Conclusions
 There are implications that increased numbers of
individual sessions and a longer period of data
collection could yield more positive results.
 The shelter that houses the SE clinic is therapy rich.
(Control - 12 therapeutic activities weekly,
Experimental - 9 activities weekly).
 Significant reduction in state symptoms of anxiety
could be a beneficial outcome for individuals who are
homeless.

19. Limitations
 Small sample size lacked statistical power
 Lack of random sampling procedures, Lack of
random assignment to groups, Lack of blinding
procedures, Lack of placebo control.
 A small number of interventions (m = 1.33 sessions
and m = 2.64 workshop series)
 Lack of measurement of physical pain, lack of
measurement of life stressors.
 Variance between measurement instances was high:
(m = 10) range of 7 to 35 days (m = 7) and a range of
7 to 35.

20. Implications
 Positive trends in the data imply that this treatment could
possibly be a cost effective resource efficient treatment protocol
the study outlined below could assess this further.
 What’s next:
 As study that includes: Random assignment, blinding
procedures, placebo and CBT control groups.
 10 session protocol (see outline).
 Measuring: PTSD symptoms, symptoms of pain, current life
stress, resilience, autonomic indicators, addictive behavior
and successful transition to more permanent housing.

22. 25
20
Depression Total
15 Symptoms Control
Group
10 Depression Total
Symptoms
5 Experimental Group
0
1 2 3 4

23. 12
10
8 Depression Cognitive
Symptoms Control
6 Group
Depression Cognitive
4
Symptoms
2 Experimental Group
0
1 2 3 4

24. 12
10
8 Depression Somatic
Symptoms Control
6 Group
Depression Somatic
4
Symptoms
2 Experimental Group
0
1 2 3 4

25. 60
50
40
State Anxiety Control
30 Group
20 Sate Anxiety
Experimental Group
10
0
1 2 3 4

26. 60
50
40
Trait Anxiety
30 Control Group
20 Trait Anxiety
Experimental
10 Group
0
1 2 3 4

27. Methods
 Data were collected for each participant on three
occasions. A sub-sample of participants were
measured five times.
 Participants were given a $5 gift card at the first
assessment and a $10 gift card at each follow up.
 Initial data collection included: Demographic survey,
BDI-II, STAI, and therapy participation form
 At follow up measurements individuals completed:
BDI-II, STAI, and therapy participation form.

28. Methods: Data analysis.
 Repeated Measures Multivariate Profile Analysis will
be used to asses all hypothesis.
 Discriminant Analysis will be used to assess all
hypothesis.
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are needed samples t-tests
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29. Affect Regulation
 Implicit Affect Regulation: Automatic regulatory
processes (Schore, 2008).
 Explicit Affect Regulation: Regulation that requires
conscious choice and use of a skill (Schore, 2008).
 Co-regulation: Regulation of affect through
relationship or inter-subjective relatedness (Schore, 2008).

30. Affect Dysregulation
Over Activated Parasympathetic…
 Physical: Low energy, exaughstion,
numbness, low muscle tone, poor
digestion, low heart rate, blood pressure,
poor immune function
(Foundation for Human Enrichment, 2007)
 Mental/Emotional: Depression,
dissociation, apathy, disconnection in
relationship, under responsive
(Foundation for Human Enrichment, 2007)
(Foundation for Human Enrichment, 2007)

31. Affect Dysregulation
Over Activated Sympathetic…
 Physical: Increase heart rate, difficulty breathing,
cold sweats, tingling, muscular tension,
exaggerated startle response, difficulty with
sleeping.
(Foundation for Human Enrichment, 2007)
 Mental/Emotional: Anxiety attacks, rage
outbursts, hyper vigilance, racing thoughts, worry
(Foundation for Human Enrichment, 2007)
(Foundation for Human Enrichment, 2007)

32. Stress Based Model of Resilience
 Homeostasis: The self regulatory processes inherent
in a system.
 Allostasis: Achieving stability in a system through
behavioral adaptations.
 Allostatic Load: The costs to the body and mind of
long-term or extreme autonomic stress.
 Health and Mental Health Risks of Allostatic
Load: Increased weight gain/loss, diabetes,
depression, PTSD, anxiety, poor immune functioning,
loss of efficiency in mental processes.

33. Why this study?
 Paradigm Shift: Resilience, affect regulation,
deterministic chaos,. and the Bodymind. (Schore, 2003;
Schore, 2008; Foundation for Human Enrichment, 2007)
 Over the last ten years there has been a growing body
of literature on resilience (Luthar, 2003).
 Much of this literature matches the assumptions
underling Somatic Experiencing theory.
 Preliminary studies show indications of SE being a
short term effective treatment (Leitch, Vanslyke, & Marisa, 2009,
Leitch, 2007).

34. Multivariate Profile Analysis
 Repeated measures multivariate profile analysis
includes three types of statistics.
 Parallelism assesses how likely is it that the lines
representing the control group and the experimental
group are parallel.
 Flatness assesses if there are changes in the dependent
variable regardless of group assignment.
 The levels statistical analysis measures the distance
between the data points across both groups.

35. Multivariate Profile Analysis
 Often in repeated measures multivariate analysis there
is a conflict between aspects of the profile.
 The method this study used to resolve differences
between findings in the statistical analysis is called
simple contrast analysis.

36. References
Foundation for Human Enrichment. (2007). Somatic
experiencing: Healing trauma training manual. Boulder,
CO: Foundation for Human Enrichment.
Luthar, S. (Ed.). (2003). Resilience and vulnerability:
Adaptation in the context of childhood adversities.
Cambridge: Cambridge University Press.
Leitch, L. Vanslyke, J., & Marisa, A. (2009). Somatic
Experiencing Treatment with Social Service Workers
Following Hurricanes Katrina and Rita. Social Work,
54(1), 9-18(10).
Leitch, L. (2007). Somatic experiencing treatment with
tsunami survivors in Thailand: Broadening the scope of
early intervention. Journal of Traumatology, 13(4)
11-20.

37. References
Levine, P. & Frederick, A. (1997). Waking the Tiger:
Healing Trauma The Innate Capacity to Transform
Overwhelming Experiences. Berkeley, CA: North
Atlantic Books.
McEwen, B. & Lasley, L. (2002). The end of stress as we
know it. Washington, DC: National Academies Press.
McEwen, B. (2003). Mood disorders and allostatic load.
Biological Psychiatry, 54(3), 200-7.
National Center for Family Homelessness (2008).
Homeless children: America’s new outcasts. Retrieved
from www.familyhomelessness.org.

38. References
Schore, A. N. (2003). Affect regulation and
repair of the self. New York, NY: W. W.
Norton & Company.
Schore, A. N. (2008). Quarterly study group on
attachment theory. Berkeley, CA: Alta Bates
Hospital.