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Case StudySSPAnxietyPhysical Challenges

Child with selective mutism and temper tantrums learns to communicate in new ways after the Safe and Sound Protocol (SSP)

🕑 3 minutes read
Posted September 27, 2023

About the Provider

Name: Verónica Hernández
Disciplines/credentials: Safe and Sound Protocol (SSP), Psychologist, M.Sc., Eye Movement Desensitization and Reprocessing (EMDR), Brainspotting, HeartMath, bilateral guided drawing
Modalities: EMDR, Brainspotting, HeartMath, trauma-certified, bilateral guided drawing, cognitive behavioral therapy (CBT), Internal Family Systems (IFS)

Client Background

Name: RC (pseudonym)
Age and Gender: 7-year-old girl
Program Delivered: Safe and Sound Protocol Core (Hours 1-5); Connect (Hours 1-5); Balance (Hours 1-3)

RC presents with selective mutism, constipation, generalized anxiety disorder (GAD), temper tantrums, impulsivity and a low frustration tolerance. RC’s parents initially consulted provider Verónica because their daughter was having difficulty transitioning from one activity to the next. She had frequent temper tantrums, constipation and frequent bathroom accidents. She also displayed anxiety in social settings and had difficulty communicating with anyone, even close family members. She lacked flexibility and was very impulsive.

Implementation of the Safe and Sound Protocol (SSP)

Due to RC’s difficult behavior, the SSP sessions were completed in person alongside provider Verónica. Initially, the sessions were 10 to 15 minutes per week. RC rejected the headphones for the first three to four weeks and opted to listen through speakers. However, as the sessions progressed, she was able to tolerate headphones for 30 minutes each week with no complaints. 

RC listened to the SSP from January to October, using the SSP Core and Connect pathways. At the end of treatment, they re-listened to small portions of hours four and five of the SSP Core pathway. Supporting modalities included CBT, play therapy, HeartMath and mindfulness. 


After the Safe and Sound Protocol (SSP), RC became less impulsive and more flexible, and her temper tantrums decreased significantly. She became more communicative and has learned to communicate in multiple ways. For example, instead of speaking, she’ll sometimes choose to write. Being able to communicate and talk about her feelings has made her less reactive. Since the SSP, she has talked to strangers and has no problem speaking with provider Verónica. She now talks to Verónica about her fears and anxieties, and explains to her mom what she feels. She is a lot more aware of situations that make her anxious.

RC still struggles with social anxiety sometimes and will choose to not speak in new situations when she anticipates rejection, but this happens a lot less often than before. She has been going to the bathroom more regularly and has almost no accidents anymore. She has become more spontaneous and has been able to adapt to new environments and situations with a lot more ease. She is changing schools and has been able to make new friends.


CBT, mindfulness and play therapy helped to support RC through the SSP. Verónica used mindfulness before the SSP, focusing on connection, attunement and feelings of safety — respecting her boundaries and readiness. Play therapy was used throughout treatment and CBT was implemented about seven months into the SSP. 

“She is a very smart child, so CBT just clicked with her. She was just ready for it,” Verónica shared. 

“I am pretty pleased with her progress. She seems to enjoy our meetings a lot. Mom is happy and has noticed important improvements,” Verónica said. 

It was a long process, but RC needed to go at a slow pace. RC’s mom shared that she has almost forgotten the last time RC had a temper tantrum. She has noticed RC being a lot more communicative of her feelings and a lot less reactive. She smiles more and her digestion has improved.

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