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Case StudySSPTrauma & PTSD

Safe and Sound Protocol (SSP) supports adoptee’s confidence, reduces sense of fear and helps with behavior

🕑 3 minutes read
Posted August 14, 2023

About the Provider

Name: Rachel Hodgdon
Disciplines/credentials: Licensed Professional Counselor (LPC)
Modalities: Child-centered play therapy, Flash Technique (FT), cognitive behavioral therapy (CBT), Safe and Sound Protocol (SSP)

Client Background

Name: Diego (pseudonym)
Age and Gender: Four-year-old boy
Program Delivered: Safe and Sound Protocol (SSP) Core (Hours 1-5)

Diego is an adoptee who was experiencing chronic trauma symptoms. He had regularly occurring nightmares, trauma triggers, aggressive behavior and a heightened fear response. Diego frequently asked questions about adoption and seemed to feel insecure in his place in the family. He seemed to have a “less-than” concept of himself and an overall low self-esteem.

Diego lives with his family and has no prior mental health treatment. He had previously gone through speech therapy, occupational therapy and physical therapy. He also had mouth surgery as a baby and has experienced some health concerns since. 

Diego’s parents brought him to SSP provider Rachel Hodgdon with the goals of helping his confidence, reducing his sense of fear and helping his behavior. His parents wanted to address his behavior, but more than anything they wanted to help him feel secure. 

Implementation of the Safe and Sound Protocol (SSP)

The SSP was delivered in person. During listening sessions, one parent stayed in the room with Diego at all times. The length of therapy sessions was one hour, twice a week. The pace depended on the day, but the child listened to about 20 minutes of the SSP at each session. 

Psychoeducation provided included information on the symptoms of trauma, Polyvagal Theory and articles from the National Child Traumatic Stress Network (NCTSN) about adoption and trauma. Diego’s parents acted as co-regulators during his listening sessions. 

During the sessions, regulating activities included deep breathing, humming, singing, fidget toys and progressive muscle relaxation. Rachel also recommended a trauma-informed book about adoption to Diego’s parents, which they read during the course of his treatment.


“Relative to [Diego’s] clinical history, the client excelled in this protocol,” Rachel shared.

Rachel used clinical measures to check his progress against the treatment goals: helping Diego’s confidence, his sense of fear and his behavior.

“The scores showed improvement levels of 30 to 80 percent on symptoms according to the following clinical assessments: Child and Adolescent Trauma Screen (CATS), the Pediatric Symptom Checklist (PSC), CES depression measure (CES-D), Short Mood and Feelings Questionnaire Parent Report (MFQ-Parent), Young Child PTSD Checklist (YCPC), and various other depression and anxiety screenings.” 

After the five hours of SSP Core, all treatment goals were achieved.


Rachel shared that one reason the SSP worked was because Diego was not ready to talk in detail about his experiences. “It worked because the parent’s were very dedicated to this intervention, and followed my recommendations flawlessly,” she said. 

Rachel has also learned the importance of meeting the client’s needs before beginning the protocol each day, such as making sure the child was not hungry, thirsty, cold, etc.

Rachel is ecstatic for Diego and his family, and is “so happy that this has improved the client’s life so much.” Diego frequently talks about Rachel to his family, even after the protocol has come to an end, and he is proud of the hard work he put into doing the SSP. Diego’s parents are very pleased with the results and have told others about the listening therapy, encouraging them to try the SSP.

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