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Case StudySSPADHDAnxietyAutonomic Nervous SystemPolyvagal Theory

The Safe and Sound Protocol (SSP) supports client in setting boundaries and forming positive social connections

🕑 4 minutes read
Posted July 24, 2023

About the Provider

Name: Aden Cosgrove
Disciplines/credentials: Registered Social Worker
Modalities: Narrative therapy, dialectical behavior therapy (DBT), Motivational Interviewing (MI), Eye Movement Desensitization and Reprocessing (EMDR), Safe and Sound Protocol (SSP), and Focus System (ILS)

Client Background

Name: Merry (pseudonym)
Age and Gender: 27-year-old non-binary 
Program Delivered: Safe and Sound Protocol (SSP)Core (Hours 1-5); Connect (Hours 1-5); Balance (Hours 1-5)

Merry first presented with social anxiety and fear of judgment a year and a half ago. They also had curiosities about the possibility of having attention deficit hyperactivity disorder (ADHD) as they presented associated features. They often felt confusion around their own emotions but identified fear as a prevalent and pervasive one. Throughout treatment, Merry also showed confusion around social norms and other symptoms of autism. Exploring and managing those symptoms has become a future treatment goal. 

Merry has been to therapy in the past but unfortunately has had moments of distrust toward their therapists due to unreliability. When they began their work with Aden, they presented with higher than normal stress levels due to  the pandemic.

Merry has been living on their own and going to school for several years. They noticed that there were relationships in their life that were unhealthy and they had a hard time setting boundaries with people.

“Since Merry had experienced poor therapeutic alliances, they did not think that they wanted to go to therapy, but TikTok had influenced them in seeking services as people talked about how helpful it can be,” Aden shared.

Implementation of the Safe and Sound Protocol (SSP)

Merry did the SSP remotely and independently while being monitored by Aden through MyUnyte, Unyte’s provider dashboard. Merry completed SSP Core over a 10-day period and then began SSP Balance, also completed within 10 days. They used SSP Connect when they felt they needed it to regulate or for self-care. 

They have done the SSP Core program three times over the past year and each time have had different positive outcomes and realizations about themselves and others. Aden has provided ongoing access to Merry and has noticed that yearlong access to SSP Balance and SSP Connect in addition to being able to do SSP Core every three months has allowed Merry to have incredible benefits. 

Prior to starting the SSP, Aden provided psychoeducation about Polyvagal Theory and the window of tolerance. Aden and Merry also mapped their autonomic nervous system (ANS). Aden said that the purpose of ANS mapping was to support Merry in understanding what was happening with the SSP, and to help them upregulate or downregulate depending on what state they were in. 

“Part of this therapeutic work is developing coping strategies that help them with managing the different ANS states,” Aden said. Merry and Aden have collaborated on creating a great rapport and therapeutic alliance, giving them the ability to have safety and co-regulation in session. 


Merry reported that they stopped going into hypoarousal, causing a collapse or dissociative states, in a maladaptive way. Prior to the Safe and Sound Protocol (SSP), slipping into this state used to be easy for them. This indicates that the vagal brake has been strengthened.   

If Merry does end up in a hypoarousal state, they do not stay in this state for long (maximum five minutes), which is a huge difference from when they used to stay in these states for longer periods of time (sometimes days). Merry also reports that right after doing SSP Core, they no longer felt dysregulated by sounds easily, a trigger that had led them to a hypoarousal or collapse state previously. 

Merry noted that during the second round of SSP Core, they did not have the same level of need to cope with cannabis, something that they have not experienced before. They also reported having more gratitude and an ability to build new and healthy connections.  


Merry’s friends noticed the positive changes in them, and now want to do the SSP themselves. Although Merry’s larger support system may not notice, Merry hardly goes into a hypoarousal state anymore, allowing them to positively connect with the people that they care about. Merry enjoys the process of the SSP and noted that they are able to separate themselves from their symptoms cognitively, which has been helpful.  

Merry followed through on doing 30-minute sessions for 10 consecutive days of both SSP Core and SSP Balance. Aden said that in their experience with their clients, “this seems to be the best method for the best possible outcome.” 

Merry has completed SSP Core three times in the past seven months and every time has found that it was positively impactful, and resulted in meaningful insights about themselves. 

“It does appear that yearly subscriptions to Unyte can have significant positive impacts for clients,” Aden said.

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