Author:

Rana Kökçinar (they/her)
Child Psychotherapist
BMedSci, BSci (Hons), MCouns&PsychTh
Accredited Safe and Sound Provider

The Safe and Sound Protocol, developed by Dr. Stephen Porges (lead developer of the Polyvagal Theory), is a five-day intervention designed to reduce stress and auditory sensitivity while enhancing capacity for social engagement and emotional resilience. The purpose of the SSP is to initiate and access a physiological state conducive to well-being, positive engagement with others, and growth in learning and therapy. Here at Expressive Therapy SA, we have been implementing the SSP within the school holidays in the last six months, and have witnessed and heard from parents about the improvements in their child’s behaviours. One family that we have been working with have given us consent to share about their experiences of the SSP as delivered by Expressive Therapy SA.

The Matthews* family have consistently accessed Expressive Therapy and Family Therapy for approximately three months through Expressive Therapy SA. Here, therapists assist Mum and a  sibling pair in developing emotional regulation strategies and support family relationships in order to address the families’ goals of increased individual independence. Mum had previously identified some auditory sensitivity in both siblings (aged 9 and 10). As we approached the school holidays, I provided some information to Mum about the SSP. I let her know that the SSP is not a stand-alone program; however, if it is delivered alongside effective therapeutic strategies (such as Expressive Therapy and Family Therapy), it can be effective in promoting physiological regulation, and subsequent behaviour change in social settings. Mum decided to book in both siblings for the SSP.

During the SSP, the siblings and I engaged in similar activities that we would in Expressive Therapy. At times we painted, played outside when it was sunny, played with balloons, foam and sensory toys. The siblings reported experiencing a small amount of frustration and tiredness during delivery of the SSP. This is very normal, as the SSP is activating certain muscles of the middle ear and causing some physiological strain and fatigue. Think of push-ups, but for your ear muscles! However, this strain is generally manageable, and the sibling pair completed the SSP within a five day period.

To assess the effectiveness of the SSP for our clients, we have parents use a measurement tool to assess the frequency of thirty-one behaviours of each child before, directly after and two weeks after delivering the SSP. Examples of behaviours measured include:

  • Explosive, flies into a rage, reactive aggression
  • Appears to withdraw or dissociate; appears to want to hide from the world or want to run away
  • Difficulties sleeping (e.g., falling asleep, staying asleep, sleeping alone)
  • Discusses ruminating or excessively worrying about things
  • Difficulties interpreting others’ or own emotions
  • Expresses feelings of hopelessness

Two weeks after the SSP was completed, Mum identified a behavioural improvement of 80% and 66% for each sibling. The following are examples of such behavioural changes: For one sibling, “expression of things feeling out of control” and “discussion of ruminating or excessively worrying about things both changed” from all of the time (5/5) pre-SSP to never (0/5) two weeks post-SSP. “Difficulty understanding and attending to others when it is noisy” moved from all of the time (5/5) pre-SSP to seldom (1/5) for the other sibling two weeks post-SSP.

The SSP can be an highly effective neurobiologically based intervention when delivered alongside other ETSA services such as Expressive Therapy and Family Therapy. Use of the SSP for each client and family is always considered in collaboration with the family, their desired goals and preferences.

We received the following feedback from Mum: “My family has been accessing services through ETSA over an extended period of time and have noticed a change in behaviour, ability to cope and communication as a family unit. We have accessed psychotherapy, family therapy and SSP. My children both have autism and anxiety, while my oldest also suffers from depression. Since commencing therapy our family unit of 3 has become much stronger and our ability to communicate has drastically increased. I have noticed a change in both my children since commencing psychotherapy, which has increased their ability to express their emotions in different ways. Both my children responded extremely well to SSP, their behaviours all decreased and some disappeared completely. Over all my children are more creative, expressive and happier.”

To learn more about the SSP, you can read more on our website here, and on the Integrated Listening Systems website here. If you are interested in enquiring or making a booking for the SSP, or any of our other services, please contact us on 08 7081 5886 or [email protected].

*Pseudonym used for privacy.