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Case StudyILSSSP

Combining the Safe and Sound Protocol and Integrated Listening System helps anxious teen boost confidence, resilience and self-regulation

🕑 6 minutes read
Posted October 20, 2023

About the Provider

Name: Catherine Stephenson
Disciplines/credentials: Bachelor of Education (B.Ed.), Masters in Inclusive Education
Modalities: Safe and Sound Protocol (SSP), Integrated Listening System

Client Background

Name: Ren (pseudonym)
Age and Gender: 16-year-old boy
Programs Delivered:

Ren’s parents describe him as highly anxious with frequent flight responses at home and school. Ren is neurodivergent and struggles to see any positives in his neurotype, which affects his self-esteem and social confidence. He spends a lot of time alone and struggles with family activities and events. He has a selective diet, often eating alone. He has had a number of high-risk behavioral incidents in response to stress that were difficult to recover from. 

Ren rarely socializes with his peers outside of an online environment and his friendships have often been acutely painful for him, at times triggering overwhelming and unmanageable feelings.

Ren lives with his family in a very supportive and loving home. His parents received coaching from his provider, Catherine Stephenson, twice a week to support them through co-regulation. Both parents work from home for a portion of the week, which has been helpful to Ren.

Ren’s school environment was becoming increasingly demanding as his statutory exams approached. He relied on one trusted member of the pastoral team at school to help him cope with stress, but this team member was not always available to work with him. This inconsistent co-regulation on one occasion led to a single-day suspension from school. 

Ren’s parents had already been working with a family therapist, who recommended the Safe and Sound Protocol (SSP) and provider Catherine. The family therapist hoped the SSP would assist Ren in emotional expression and support his engagement at the family therapy sessions, which would then help the whole family process the issues that brought them all to this point. 

Implementation of the Safe and Sound Protocol (SSP) and Integrated Listening System (ILS)

When Ren began the SSP, strict COVID-19 safety measures were in place that restricted in-person support from Catherine. Following online meetings to build the relationship between Ren, his parents and Catherine, they agreed to begin remote SSP delivery, and started with 15-minute daily SSP listening sessions. His Measure of Foundational Abilities (MFA) indicated moderate sensitivity. During the listening process, Ren grew more anxious at school, feeling increasingly unsafe. Due to the lack of safety, Catherine paused the SSP sessions until conditions of safety increased during the school summer break.  

Considering Ren’s MFA, it was agreed that the Integrated Listening System (ILS) might help him meet the intended outcomes of improved self-regulation and increased self-confidence while they paused any further SSP delivery. They began the ILS Optimal Performance I program, following the use of the ILS Playbook (1). With intensive co-regulation from Catherine, they completed the program over a six-week period. At the end of the program, Ren and Catherine designed and co-wrote training for Ren’s school on the role of the nervous system, helping to support other young, neurodivergent people. 

Ren completed the Integrated Listening System program, but his school environment didn’t change. This gradually increased his anxiety and made it difficult for him to manage stress at school, so his parents and school agreed to a temporary part-time attendance with some online learning. 

By April, the conditions of safety were consistent enough for Ren to restart the SSP, as COVID-19 safety measures had changed, allowing for a new delivery approach. 

Ren and Catherine completed one co-listening session weekly, complemented with remote sessions using body doubling: Ren chose drawing activities that were mirrored by Catherine.  Due to Ren’s response to the SSP last time, Catherine slowed the listening sessions to 10 minutes per session for four sessions a week. 

Catherine also took a coaching approach with Ren, honing in on his interests and teaching him about Polyvagal Theory-based regulating techniques, and used the ILS Playbook activities repeatedly for body regulation. At this point, Ren only attended school for social connection with a pastoral lead. This opportunity for connection provided added therapeutic input and a place to apply the strategies he was learning and developing. 

(1) The ILS Playbook has been replaced with the digital ILS Activity Library.


Within weeks of completing both the Integrated Listening System’s Optimal Performance I program and the Safe and Sound Protocol (SSP), Ren applied and interviewed for college. A few months later, he began attending college full-time, made and sustained friendships, and independently initiated a career in voice acting. Within a year of completion, he completed exams and gained qualifications, won a prize for best attendance, engaged in ambassador work for the college, and presented his own PowerPoint to prospective students at an open day. 

Using the Integrated Listening System (ILS) enabled Catherine to actively listen to Ren’s communication through verbal and non-verbal cues. Through decreased scores, the MFA showed how the ILS activated his body: structured movements, combined with trusted co-regulation from Catherine, resulted in more flexibility and responsiveness through brain-body integration.  

The MFA was completed on three occasions: May 21, November 21 and July 22. 

  • In the Social-Emotional domain, scores decreased from 42, to 37, to 21. 
  • In the Cognitive and Attention domain, scores changed from 46, to 51, and finally decreased to 38.
  • In the Sleep domain, scores decreased from 16 to 8.

Panksepp’s emotional brain systems were measured by emotional, qualitative questionnaires by family and school in May and November. Increases were significant in:

  • Enthusiasm for connection and life (Panksepp’s seeking). 
  • The ability to handle stress and emotional literacy skills. 
  • Self-regulation and resilience, shown through decreases in fear, rage, panic and grief systems.  

Ren’s family has reported:

  • Increased self-regulation and decreased flight responses, as he now seeks support when he needs it. 
  • Improved confidence, developing and sustaining friendships, enjoyment of family holidays, and taking trips abroad with increasing independence. 
  • Eating with the family. 
  • More positively identifying with his neurotype, and gaining social and learning confidence.

Ren’s parents say he is “turning into a confident young person” and “[is] more open emotionally.” He has begun approaching his parents for advice, making mature decisions, and becoming much more resilient. Ren’s mother says that he “still has challenges, but is able to deal with them in a less [self-destructive] way.” 


Catherine explained that it was critical to gather information about the level of psychological safety Ren felt in all environments. Although this initial information allowed them to change their delivery pace in their sessions, Catherine regretted not emphasizing Ren’s environmental needs to his school, as distressing events may have been avoided if they had. 

Since this realization, Catherine has started making a checklist on aspects of school provision relating directly to the Neuroception of Psychological Safety Scale (NPSS). She hopes to continuously build evidence on how vital this is for young people’s connection and engagement with relationships and learning in school. 

Resuming the SSP after the completion of the ILS — when Catherine could provide in-person co-regulation — brought the desired results. 

“I have since applied the Integrated Listening System sandwiched between rounds of SSP to explore the benefits with another client who has more complex needs, and it is beginning to reveal similar results,” Catherine said. “The intensity of the work was a strength, and this has given me more conviction to invest the time and energy into the therapeutic play aspects of SSP and the Integrated Listening System.”

At nearly 18 years old now, Ren is making more accurate deductions about his own life skills, as he starts to reflect and draw upon experiences, viewing them as positive growth. 

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