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Case StudySSPPolyvagal TheoryTrauma & PTSD

The Safe and Sound Protocol (SSP) is the “missing piece” to client’s recovery after PTSD

🕑 4 minutes read
Posted July 21, 2023

About the Provider

Name: Alycia O’Connell
Disciplines/credentials: Licensed Clinical Social Worker (LCSW), Certified Alcohol and Drug Counselor (CADC III)
Modalities: Eye Movement Desensitization and Reprocessing (EMDR), Flash technique, cognitive behavioral therapy (CBT), Motivational Interviewing (MI), Safe and Sound Protocol (SSP)

Client Background

Name: Joana (pseudonym)
Age and Gender: 67-year-old woman
Program Delivered: Safe and Sound Protocol (SSP) Core (Hours 1-5); Connect (Hours 1-5)

Joana presents with PTSD, and has a long history of trauma dating back to childhood and continuing throughout her life. She was raised by a parent with narcissistic personality disorder and suffered a lot of abuse as a child. Abuse continued to be present in her relationships moving forward. 

Joana has never been in therapy before. At the start of treatment, she had taken the steps to get out of her 22-year marriage, which was a physically and emotionally abusive and dangerous relationship. Her husband had been incarcerated for abuse and threats toward Joana. Because of the abusive relationship, she had lost many friends, family and her job. She currently lives with her son, who also struggles with his relationship with his dad. 

Joana had often vacillated between letting her husband back into her life and standing her ground. After several threats while she was already in therapy, she ended up getting back together with her husband. Unfortunately, while she was in therapy, she was also going through cancer treatment and upon suffering additional abuse from her husband at that time, she finally ended the relationship permanently. Joana was often stuck in a dorsal vagal state and struggled to stick up for herself. 

Joana came to treatment to work on her PTSD diagnosis. At the start of treatment, she identified the following goals:

  1. Finding my voice
  2. Self esteem
  3. Being able to say no
  4. Reconnecting with family relationships strained due to her previous relationship.

Implementation of the Safe and Sound Protocol (SSP)

The SSP was delivered remotely. Alycia explained that Joana was the most hypervigilant client she has used the SSP with. 

After the first listening session, which was completed independently, Joana checked in with Alycia and gave updates on her reactions to each song in detail (for example, the clapping in the happy song was extremely activating to her). Despite this, she resisted slowing down and wanted to push through. She said 15-minute listening sessions were almost intolerable, but she was able to do it if she continued on for 30 minutes. This prompted them to slow down the length of listening sessions. Alycia was able to explain why they needed to slow down and moving forward Joana completed her sessions one song at a time. 

There was a lot of daily support around adjusting the program delivery and teaching Joana to listen to her body. She had an understanding of Polyvagal Theory from her therapy with Alycia and was able to better understand what was happening. Prior to the SSP, they mapped out Joana’s nervous system, which she found helpful, often using the terminology. 


Joana has had amazing results from the Safe and Sound Protocol (SSP). Alycia shared that “it was the missing piece to her recovery.” 

Before the SSP, Joana hadn’t listened to music in 45 years and now she’s enjoying music. Previously, Joana felt dread and fear that her ex was lurking around the corner. Now, she says that she has “no more terror feelings,” feels in control and no longer feels constant dread. 

The SSP also helped her become more in tune with herself and what she does and doesn’t like. 

“At our last session, she said she was talking to a friend about therapy ending and said that she knows she will be OK,” Alycia added.


“Everyone has been impressed with the success this client has had,” Alycia said. Joana has since reunited with many friends and family and is enjoying time with them. She has been traveling with family and is finally in charge of and enjoying her life. 

“I was amazed by seeing the powerful effects that the SSP made,” Alycia said. (Although Joana made so much progress, her trauma went back so far that there was no baseline to return to. Alycia wasn’t sure her nervous system had ever felt completely safe).

For Alycia, this was a great reminder about going slow with clients and educating them on why taking as much time as needed with the SSP is so important. With Joana listening to one song at a time per session, Alycia said, “She had the most amazing effects of all my clients.” Alycia said. 

Alycia has also started completing the first listening session with her clients so that she can monitor and see how they respond to and understand the technology. For clients experiencing the Safe and Sound Protocol (SSP) for the first time, she does daily check-ins and is more likely to start with Connect rather than Core now. 

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