Body oriented interventions to help regulation of arousal for people with problems related to psychotrauma

Clients with trauma-related problems often suffer from problems in arousal
regulation, which are the result of a chronic dysregulation of the stress
system. The arousal level may be too high, hyperarousal. This is reflected in a
continuous feeling of fear and increased alertness, regularly also in
aggressive behaviour. On the other hand, there may be too low arousal, or
hypoarousal. Contact with one's own body is often greatly reduced and there is
dissociation. Problems in arousal regulation are currently moderately addressed
within the regular treatment offer. However, these problems do have a
significant impact on daily functioning. That is why specific attention is
important. This is also emphasized by clients, who state that additional
body-oriented treatments aimed at restoring contact with the body and skills in
arousal regulation are necessary. There are indications that a body-oriented
approach is suitable for learning to regulate arousal and that other PTSD
symptoms also decrease after such an offer. However, the intervention is hardly
standardized and there is also little insight into the results.

The project evaluates an intervention aimed at arousal regulation.
The research questions are:
- Is there an improvement in signaling body signals and in arousal regulation
after following this program?
- Does this also lead to positive changes in daily life, such as the
experienced direction and contact with one's own body.

The treatment is distributed and evaluated at two institutions for trauma
treatment: Heelzorg Psychotrauma in Zwolle and Transit Psychotrauma, part of
GGZ Centraal, in Ermelo.
For the evaluation we use a mixed method design:
- A quantitative N=1 study with multiple baseline across subjects, using
repeated measures during the baseline (with varying duration per individual),
the intervention period (8 weeks) and the follow-up (12 weeks). Such an
approach is in line with practice.
- In qualitative interviews, themes such as giving meaning to control over
one's own body, restoring contact with one's own body and its influence on
intimate and social contacts are discussed. These themes cannot be addressed
sufficiently through questionnaires.

In collaboration with clients, psychomotor therapists have developed a
body-oriented intervention of eight weekly sessions to improve arousal
regulation. The offer is integrated into the regular treatment, in such a way
that there is as little disruption as possible to the usual treatment practice,
but that a new and relevant treatment offer is added.

The intervention that is offered concerns a standardized range of treatment
elements that are already present in treatment practice. For this reason, the
risk is not increased compared to regular treatment. The burden on the clients
also consists of filling in two questionnaire four times (total 20 minutes each
time), a few questions every week (5 minuten) and participating in an interview
after the module (60 minutes). In practice, such deployment is not experienced
as a great burden.